c 


V 


JOHNA.SEAVERNS 


II 
9090 


III  III  III  III  I 
013  413 


I    II 
485 


Webster 

icineat 

North  Grafton,  MA  01536 


DISEASES  OF  THE  HORSE'S  FOOT 


DISEASES 


OF 


THE  HORSE'S  FOOT 


BY 


H.  CAULTON  REEKS 

FELLOW   OF   THE   ROYAL   COLLEGE    OF    VETERINARY    SURGEONS 
AUTHOR    OF    'THE    COMMON    COLICS    OF    THE    HORSE ' 


CHICAGO 

ALEX.     EG  E  R 

1918. 


TO 

J.  MACQUEEN,  F.R.C.V.S., 

PROFESSOR   OF   SURGERY   AT  THE   ROYAL   VETERINARY    COLLEGE,    LONDON, 

AS    A    SLIGHT    ACKNOWLEDGEMENT    OF    HIS    ABILITY    AS    A 
TEACHER,    AND    IN    RETURN    FOR    MANY    KINDLY 
SERVICES,    THIS    VOLUME    IS    GRATE- 
FULLY   INSCRIBED 


THE  AUTHOR 


PREFACE 

Stimulated  by  the  reception  accorded  my  '  Common  Colics 
of  the  Horse/  both  in  this  country  and  in  America,  and 
assured  by  my  publishers  that  a  work  on  diseases  of  the 
foot  was  needed,  I  have  been  led  to  give  to  the  veterinary 
profession  the  present  volume. 

While  keeping  the  size  of  the  book  within  reasonable 
limits,  no  effort  has  been  spared  to  render  it  as  complete 
as  possible.  This  has  only  been  achieved  by  adding  to  my 
own  experience  a  great  deal  of  the  work  of  others.  To 
mention  individually  those  who  have  given  me  permission 
to  use  their  writings  would  be  too  long  a  matter  here.  In 
every  case,  however,  wThere  the  quotation  is  of  any  length, 
the  source  of  my  information  is  given,  either  in  the  text  or 
in  an  accompanying  footnote.  A  few  there  are  who  will, 
perhaps,  find  themselves  quoted  without  my  having  first 
obtained  their  permission  to  do  so.  They,  with  the  others, 
will,  I  am  sure,  accept  my  hearty  thanks. 

The  publishers  have  been  generous  in  the  matter  of 
illustrations  and  diagrams,  and  although  to  the  older  prac- 
titioner some  of  these  may  appear  superfluous,  it  is  hoped 
they  will  serve  to  render  the  work  an  acceptable  text-book 
for  the  student. 

H.  CAULTON  REEKS. 

Spalding, 

January,  1906. 


Vll 


CONTENTS 


CHAPTER  I. 


INTRODUCTION 


PAG  E 

I 


CHAPTER  II. 
REGIONAL  ANATOMY 

A.  The  Bones 

B.  The  Ligaments 

C.  The  Tendons 

D.  The  Arteries 

E.  The  Veins 

F.  The  Nerves 
'G.  The  Complementary  Apparatus 
H.  The  Keratogenous  Membrane 
I.  The  Hoof    .... 


)f  the 


Os  Pedis 


7 

12 

1/ 
22 
26 
28 

30 

3-7 
37 


CHAPTER  III. 

GENERAL    PHYSIOLOGICAL   AND  ANATOMICAL  OB 
SER  VAT  IONS  .... 


A.  Development   of  the  Hoof    .... 

B.  Chemical   Properties  and   Histology  of  Horn 

C.  Expansion  and  Contraction  of  the  Hoof 

D.  Functions    of    the    Lateral    Cartilages 

E.  Growth   of   the  Hoof    ..... 


44 

44 
58 
62 
66 
69 


'CHAPTER  IV. 
METHOD  OF  EXAMINING  THE   FOOT 

ix 


71 


CONTENTS 


CHAPTER    V. 

page: 
GENERAL  REMARKS  ON  OPERATIONS  ON  THE  FOOT    77 


A. 

B. 
C. 

D. 


E. 
F. 
G. 


Methods  of  Restraint  . 
Instruments    required    . 
The   Application   of   Dressings 
Plantar  Neurectomy     . 

History    of    the    Operation 

Preparation   of  the   Subject 

The    Operation 

After-treatment 
Median  Neurectomy 
Length   of   Rest  after   Neurectomy 
Sequela-   of    Neurectomy 

Liability  of  Pricked  Foot  going  undetected 

Loss  of  Tone  in  the  Non-sensitive  Area 

Gelatinous   Degeneration    . 

Chronic    (Edema   of   the   Leg    . 

Persistent    Pruritus 

Fracture   of  the   Bones 

Neuroma   ...... 

Reunion  of  the  Divided  Nerve. 

The  Existence  of  an  Adventitious  Nerve-supply 

Stumbling  .... 

Advantages  of  the  Operation 
The  Use  of  the  Horse  that  has  undergone  Neurectom\ 


CHAPTER  VI. 
FAULTY  CONFORMATION 

A.  Weak  Heels 

B.  Contracted  Foot   .... 

(a)  Contracted    Heels 

(b)  Local    or    Coronary    Contraction 

C.  Flat-foot 

D.  Pumiced-foot,  Dropped  Sole,  or  Convex  Sole 

E.  'Ringed'   or   'Ribbed'   Hoof    . 

F.  The  Hoof  with  Bad  Horn   . 

(a)  The  Brittle  Hoof       . 

(b)  The    Spongy   Hoof      . 

G.  Club-Foot     .         . 
H.  The    Crooked    Foot 

(a)  The  Foot  with  Unequal  Sides 
(/;)   The    Curved    Hoof     . 


CONTEXTS 


CHAPTER  VII. 

PAGE 

DISEASES   ARISING  FROM  FAULTY  CONFORMATION  161 


B. 


Sand-crack    .         .          ... 

161 

Definition            ..... 

161 

Classification      ..... 

161 

Causes        ...... 

162 

Complications    ..... 

168 

Treatment           ..... 

170 

Surgical   Shoeing   for    Sand-crack 

175 

Corns    ....... 

182 

Definition            ..... 

182 

Classification       ..... 

183 

Causes       ...... 

183 

Pathological     Anatomy    and     Histology 

191 

Treatment          ..... 

197 

Surgical   Shoeing   for   Corn 

200 

Chronic  Bruised  Sole   .... 

203 

CHAPTER  VIII. 


WOUNDS  OF  THE  KERATOGENOUS  MEMBRANE 


V./J.         J.J.i-1^      IVLlV.liUVJi.^UCJ      -Uij 

rwN  l 

•      ^>h 

Nail-bound    ..... 

•  205 

Definition   ..... 

•    20.t 

Causes        ..... 

•    205 

Symptoms   ..... 

.    206 

Treatment           .... 

.    206 

Punctured  Foot    .... 

.    207 

Definition   ..... 

.    207 

Causes       ..... 

.    207 

Common  Situations  of  the  Wound 

.    209 

Classification      .... 

.    209 

Symptoms  and  Diagnosis   . 

.    210 

Complications    .... 

.    214 

Prognosis  ..... 

•    217 

Treatment  ..... 

.    219 

Coronitis     (Simple) 

.    229 

1.     Acute   ..... 

.    229 

Definition 

.    229 

Causes  ( 

.    229 

Symptoms 

.    231 

Complications    . 

•    232 

Prognosis 

•    234 

Treatment 

•    235 

XI 1 


CONTENTS 


D. 


PAGE 

2.     Chronic    . 

.   240 

Definition 

.   240 

Causes     . 

.   240 

Symptoms 

•   241 

Treatment 

.   242 

False  Quarter 

245 

Definition 

•    24.t 

Causes     . 

.  246 

Treatment 

.  246 

Accidental  Tearing 

off 

of  the  Entire  Hoof   . 

.  217 

CHAPTER  IX. 


INFLAMMATORY    AFFECTIONS   OF    THE    KERATO- 

GENOUS  APPARATUS 256 

A.  Acute 

Acute   Laminitis 
Definition 
Causes 
Symptoms 

Pathological  Anatomy 
Complications   . 
Diagnosis  and  Prognosis, 
Treatment 

Broad's   Treatment    for   Laminitis 
(Smith's    Operation    for    Laminitis 

B.  Chronic  .... 

1.  Chronic    Laminitis 

Definition 
Causes  , 
Symptoms 

Pathological  Anatomy 
Treatment 

2.  Seedy-Toe    . 

Definition 
Causes  . 
Symptoms 
Treatment 

3.  Keraphyllocele 

Definition 
Causes 
Symptoms 
Treatment 

4.  Keratoma     . 


C<  INTENTS 


Xlll 


6. 


I 

•AGE 

Thrush          ....                    .          . 

3o3 

1  Vefinition         ...... 

3o3 

Causes      ....... 

3d3 

Symptoms         ...... 

3o4 

Treatment         ...... 

3o5 

Canker          ....... 

3o6 

Definition          ..... 

3o6 

Causes,  Predisposing"  and  Exciting   . 

3d6 

Symptoms    and    Pathological    Anatomy    . 

3io 

Differential    Diagnosis    and    Prognosis     . 

3i4 

Treatment        ...... 

3i4 

Malcolm's.    Lieutenant   Rose's,    Bermbach's, 

Hoffmann's  and   Imminger's  Treatment  for 

Canker           ...... 

3.i6 

Specific    Coroniti-;          ..... 

324 

Definition          ...... 

324 

Causes      ....... 

325 

Symptoms         ...... 

321 

Treatment         ...... 

326 

CHAPTER  X. 
DISEASES  OF  THE  LATERAL  CARTILAGES  .         .         .   32$ 

A.  Wounds  of  the  Cartilages      ......    328 

B.  Quittor 320 

Definition  .......    029 

Classification      ...  ...   32Q 

t.     Simple   or    Cutaneous    Quittor      ....   33o 

Definition  .......   33o 

Causes      ........   33o 

Symptoms         .  .  .  .  .  .  .   33 1 

Pathological    Anatomy      .....   332 

Prognosis  .......   332 

Complications  ......  332 

Treatment,    Preventive   and    Curative       .  .   333 

2.     Sub-horny    Quittor        ......   33$ 

Definition         .......   33$ 

Causes     ........   33^ 

Symptoms    and    Diagnosis        ....   336 

Complications  ......    33j 

Necrosis  of  the  Lateral  Cartilage    .  .  .   33~ 

Pathological  Anatomy  of  the  Diseased  Cartilage  33q 
Necrosis  of  Tendon  and  of  Ligament     .  .   340 

Ossification    of   the    Cartilage  .  .  .   342 

Treatment       .......     342 

Operations    for    Extirpation    of    the    Cartilage  351 


CONTENTS 

PAGE 

C.     Ossification  of  the  Lateral   Cartilages    (Side-bones)      .  365 

Definition        ........  365 

Symptoms   and   Diagnosis       .....  365 

Causes 368 

Treatment       .          .          .          .          .         .          .          .  37i 

Smith's  Operation  for  Ossification  of  the  Lateral 

Cartilages 373 


CHAPTER  XI. 
DISEASES    OF  THE   BONES       . 

A.  Periostitis  and  Ostitis    . 

i.     Periostitis    .... 

(a)  Simple  Acute   Periostitis 

(b)  Suppurative  Periostitis 

(c)  Osteoplastic  Periostitis 
2.     Ostitis  .... 

(a)  Rarefying  Ostitis 

(b)  Osteoplastic    Ostitis 

(c)  Caries    and    Necrosis 
Treatment    of    Periostitis 
Recorded   Cases    of    Periostitis 

B.  Pyramidal  Diseases,  Buttress  Foot,  oi 

Definition        .... 
Symptoms   and   Diagnosis 
Pathological  Anatomy   . 
Treatment       .... 
Recorded    Cases    of    Buttress    Foot 

C.  Fractures   of  the  Bones 

i.     Fractures  of  the  Os  Coronas 

Recorded  Cases  of  Fractures  of  the 
nse 

2.  Fractures   of  the   Os   Pedis 

Recorded  Cases  of  Fractures  of  th 

3.  Fractures  of  the  Navicular  Bone 

Recorded   Case  of   Fracture  of   the 
Bone    .... 


Low 


Ringl 


.  402 

.  406 

Os  Pedis  406 

.  408 

Navicular 

•  409 
Treatment  of  Fractures  of  the  Bones  of  the  Foot  411 


Os  Coro 


38o 

38o 
382 
382 
383 
384 
386 
386 
387 
387 
388 
389 
395 
395 
396 

397 
397 
397 
401 
402 


CHAPTER  XII. 

)ISEASES  OF  THE  JOINTS       . 

.  4i3 

A.     Synovitis       ...... 

.  4i3 

(a)   Simple    ..... 

.  4i3 

(1)   Acute        .... 

.  4i3 

(2)   Chronic     .... 

•   41.=? 

(b)   Purulent   or    Suppurative 

•  4T7 

CONTEXTS 


xv 


D. 


PA<    E 

Arthritis .417 

(a)   Simple   or    Serous    . 

4i7 

(b)   Acute 

417 

(c)   Purulent  or   Suppurative 

418 

(d)   Anchylosis       .... 

4-7 

Navicular   Disease          .... 

427 

Definition        .... 

42/ 

History        ..... 

428 

Pathology       .... 

428 

Changes  in  the  Bursa 

429 

Changes  in  the  Cartilage  . 

43o 

Changes  in  the  Tendon    . 

43 1 

Changes  in  the   Bone 

43 1 

Causes    ..... 

433 

Heredity 

433 

Compression    . 

433 

Concussion 

43.^ 

A  Weak  Navicular  Bone 

.  436 

An    Irregular    Blood-supply    t 

0    the 

Bor 

ie 

•  437 

Senile   Decay    . 

.  437 

Symptoms   and   Diagnosis 

•  437 

Differential    Diagnosis    .          . 

•  44i 

Prognosis        .... 

•   443 

Treatment       ... 

•  443 

Dislocations           .... 

•   446 

LIST  OF  ILLUSTRATIONS 


KIG. 

I. 
2. 

3. 
4- 
5- 
6. 

7- 
8. 


PAGE 

The   Bones  of  the   Phalanx         .  ...       7 

The  Os  Coronas  (Anterior  View)  .....  8 
The  Os  Coronas  (Posterior  View)  .....  8 
The  Os   Pedis    ( Postero-lateral  View)        .  .  .  .     n 

The  Os  Pedis  (view  from  Below)       .  .  .  .  .      n 

The   Navicular   Bone    (viewed   from   Below)        .  .  .      i3 

The   Navicular   Bone    (viewed   from  Above)       .  .  .      i3 

Ligaments    of   the    First    and    Second    Interphalangeal   Ar- 
ticulations  (Lateral  View).    (After  Dollar  and  Wheatley)     14 
Ligaments  of  the  First  and  Second  Interphalangeal  Articu- 
lations (viewed  from  Behind.)  (After  Dollar  and  IVheatley)      16 
The   Flexor   Tendons   and    the    Extensor    Pedis.       (After 

Haubner) 18 

The   Flexor   Perforans   and   Perforatus       .  .  .  .19 

The  Flexor  Perforans  and  Perforatus   (the  Perforans  cut 
through  and  deflected)       .......     20 

Median    Section   of   Normal    Foot       .  .  .  .  .21 

The    Arteries    of    the    Foot         .  .  .  .  .  .2.4 

The  Veins  and  Nerves  of  the  Foot      .  .  .  .  .29 

The  Lateral  Cartilage       .......     3i 

The  Keratogenous  Membrane  (viewed  from  the  Side)  .  34 
The    Keratogenous    Membrane    (viewed    from    Below)        .     3fS 

The  Wall  of  the  Hoof 38 

Internal  Features  of  the  Hoof   .         .  .  .  .  .     3o 

Inferior  Aspect  of  the  Hoof       .  .  .  .  .  •     41 

Hoof  with  the  Sensitive  Structures  removed       .  .  .42 

Section    of    Epidermis         .......     45 

Section  of  Skin  with  Hair  Follicle  and  Hair      .  .  .48 

Section   of    Human    Nail    and   Nail-bed       .  .  .  -49 

Section  of  Foot  of  Equine  Foetus.    (Met tain)      .  .  •     53 

Section  from  Foot  of  Sheep  Embryo.    (Mettam)       .  .     $3 

Section  from  Foot  of  Calf  Embryo.    (Mettam)    .  .  -54 


xvi  1 


XV111 


LIST  OF  ILLUSTRATIONS 


FIG.  PAGE 

29.  Section    from   Foot    of    Equine    Foetus.     (Mettam)      .  .     55 

30.  Section  through  Hoof  and  Soft  Tissues  of  a  Foal  at  Term 

(Mettam) 

3i.  Perpendicular  Section  of  Horn  of  Wall 

32.  Horizontal    Section   of    Horn    of    Wall 

33.  Horizontal  Section  through  the  Junction  of  the  Wall  with 
the  Sole     .......... 

34.  Section   of  Frog.     (Mettam) 

35.  Professor   Lungwitz's   Apparatus   for   Examining  the   Foot 
Movements         .... 

36.  Professor  Lungwitz's  Apparatus   for  Examining  the  Foot 
Movements         .... 

37.  The  Movements  of  the   Solar  and  Coronary  Edges  of  the 
Hoof  illustrated.     (Lungimtz)    .... 

38.  The  Blind 

39.  The  Side-line      ....... 

40.  Method  of  securing  the  Hind-foot  with  the  Side-line 

41.  The  Hind-foot  secured  with  the  Side-line 

42.  The  Casting  Hobbles  ..... 

43.  Method  of  securing  the  Hind-leg  upon  the  Fore 

44.  The  Hind-leg  secured  upon  the  Fore  . 

45.  The  Drawing-knife    (Ordinary  Pattern) 

46.  Modern  Forms  of  Drawing-knives 

47.  Symes's   Knife    ..... 
48-51.    Illustrating     Colonel     Nunn's     Method 

Poultice  to  the  Foot 

52.  Poultice-boot  of  Canvas  and  Steel     . 

53.  Poultice-boot    of    Cocoa-fibre 

54.  Foot-swab  ..... 

55.  The    Shoe   with    Plates 

56.  Quittor    Syringe    ..... 

57.  The   Esmarch  Bandage  and  Tourniquet 

58.  Tourniquet  with   Wooden    Block 

59.  Neurectomy    Bistoury  .  .  . 

60.  Neurectomy    Needle 

61.  Double    Neurectomy    Tenaculum 

62.  Adventitious  Nerve-supply  to  Foot. 

63.  Tip    Shoe  ..... 

64.  The  Tip   Shoe   '  let   in  '   to   the   Foot 

65.  The   Thinned   Tip        .... 

66.  Drawing-knife    for    Charlier    Shoeing 

67.  The   Foot   prepared    for  the   Charlier   Shoe 

68.  Bar    Shoe 

69.  Rubber   Bar   Pad   on   Leather     . 
70.  The  Bar  Pad  applied  with  a  Half-shoe     . 


of     applying 


(Sessions) 


88 

89 

90 

90 

95 

95 

96 

95 

97 

106 

^2$ 

126 

126 

127 

127 

128 

129 

129 


LIST  OF  ILLUSTRATIONS 


xix 


FIG. 
71. 
72. 

73. 

74- 
75- 
76. 

77. 
7^. 
79- 
80. 
81. 
82. 
83. 
84. 
85. 
86. 
87. 
88. 
89. 
90. 
91. 

92. 

93. 

94- 
97- 
98. 
99. 
100. 

101. 

102. 
io3. 
104. 
105. 
106. 
107. 

108. 
109. 


(Gutenacker) 
( Gutenacker) 


Frog  Pad  

Frog    Pad    applied     ..... 

Smith's  Expansion  Shoe  for  Contracted  Feet 

A  Contracted  Foot  treated  with  Smith's  Shoe 

De   Fay's  Vice  ..... 

Hartmann's   Expanding   Shoe 

Broue's    Slipper    Shoe.      (Gutenacker) 

EinsiedeFs  Slipper  and  Bar-clip  Shoe 

Hoof   showing   Coronary   Contraction 

Flat-foot    (Solar    Surface).     (Gutenacker) 

Hoof   showing  Laminitis  Rings  on  the  Wall.      (Gutenacker) 

Hoof  showing  "Grass'  Rings  on  the  Wall.      (Gutenacker) 

Club-foot.      (Gutenacker)  .... 

Shoe  with    extended   Toe-piece.      (Gutenacker) 

A  Crooked  Foot  in  Cross-section.     (Gutenacker) 

Sand-crack   Firing-iron        ..... 

Sand-crack  Forceps  and  Clamp.    (J'achette's) 

McGill's  Sand-crack  Clamp         .... 

Koster's    Sand-crack    Clamp        .... 

Sand-crack    Belt 

Method  of  '  Easing  '  the  Bearing  of  the  Wall  on  the  Shoe 

in  the  Treatment  of  Sand-crack 

Method  of 'Easing'  the  Bearing  of  the  Wall  on  the  Shoe 

in  the  Treatment  of  Sand-crack 

Method  of  '  Easing '  the  Bearing  of  the  Wall  on  the  Shoe 

in   the  Treatment  of  Sand-crack  .... 

96.  Grooving  the  Wall  in  the  Treatment  of  Sand-crack 
Removing  the  Wall   in  the  Treatment  of  Sand-crack 
Removing  the  Wall  in  the  Treatment  of   Sand-crack 
Horizontal    Section    of    Corn.     (Gutenacker) 
Inner   Surface   of   the   Wall,   showing   Changes  in   Chronic 
Corn.      (Gutenacker) 
Perpendicular  Section  of  the    Wall  in  a   Case   of   Chronic 
Corn.     (Gutenacker) 
Three-quarter    Shoe    .... 

Three-quarter  Bar  Shoe 

Shoe  with  a  '  Dropped  '  Heel 

Shoe  with  a  '  Set     Heel 

Curette,    or   Volkmann's    Spoon 

Resection     of    the     Terminal     Portion    of 

Tendon.       (Gutenacker)      ...... 

Shoe  with  extended  Toe-piece.     (Colonel  Xunn) 
Medial   Section    of  Foot  with  Lesions  following  Coronit 
(Gutenacker)     ........ 

Toe  of  Ordinary  Hind-shoe 


PAGE 

129 
129 
i3o 

1 32 

i34 
i3* 

i36 
1 36 
141 
144 
147 
149 
154 
156 
160 
171 
172 
172 
173 
174 


194 

201 

20  T 

202 

202 

223 

the 

Perforans 

176 
176 

177 
179 
181 
181 
192 

193 


228 

233 
236 


xx  LIST  OF  ILLUSTRATIONS 

FIG.  PAGE 

in.  Toe  of  Hind-shoe  Bevelled  for  the  Prevention  of  Overreach  236 
112.  Hoof    showing    Lesion    in    the    Wall    following    Coronitis. 

(Gutenacker)  ........   240 

n3.  Foot  with  Lesions  of  Chronic  Coronitis.  (Gutenacker)  244 
1.14.  Hoof  Accidentally  Torn  from  Foot.     (Cartledge)      .         .  252 

115.  Hoof   Accidentally  Torn   from  Foot.     (R'ogerson)      .  .   254 

116.  Section    of    Foot    with   Laminitis    of    Eight    Days'    Duration. 
(Gutenacker)     .........  265 

117.  Section  of   Foot  with  Laminitis  of  Fourteen  Days'  Dura- 
tion.    (Gutenacker)  .......  266 

118.  Chronic  Ostitis  of  the  Os  Pedis  in  Laminitis     .  .  .   270 

119.  Broad's  Rocker   Bar  Shoe   for  Laminitis  .  .  .   274 

120.  The  Foot  showing  'Grooves  made  in  the  Wall  for  Treat- 
ment  of   Laminitis    (Anterior   Surface)      ....   278 

121.  The    Foot    showing   Grooves    made    for   the   Treatment   of 
Laminitis    (Solar    Surface)  ......   270. 

122.  Foot    with     Chronic    Laminitis.      (Gutenacker)  .  .   284 

123.  Inferior   Aspect  of   Foot  with  Chronic  Laminitis. 
(Gutenacker)     .........  285 

124.  Section   of    Foot   with   Laminitis   of   Three   Weeks'   Dura- 
tion.    (Gutengcker)  .......  286 

125.  Section  of  Foot  with  Laminitis  of  Several  Years'  Duration. 
(Gutenacker)  ........   288 

126.  Diagram   showing   Position  of   the   Abnormal   Growth   of 
Horn  in  Chronic:  Laminitis         ......   2go 

127.  Diagram    showing   the    same    Abnormal   Growth    of    Horn 
Removed  prior  to   Shoeing         ......  290 

128.  Shoe   with   Heel-clip 2gi 

129.  Internal    Seedy-Toe    ........   294 

i3o.  External    Seedy-Toe.     (Colonel    Nunn)      ....  295 

i3i.  External    Seedy-Toe.     (Colonel    Nunn)      ....  295 

i32.  A  Keraphyllocele  on  the  Inner  Surface  of  the  Horn'  of  the 

Wall  at  the  Toe.     (Gutenacker)         .....  298 
i33.  Os    Pedis    showing    Absorption    of    Bone    caused    by    the 

Pressure   of   a   Keraphyllocele.     (Gutenacker)  .  .   3o2 

134.  Foot  with   Canker  of  the  Frog  and  Heels.     (Gutenacker)   3io 

135.  Foot  with  Canker  extending  to  the  Wall.  (Malcolm)  .  3i2 
i36.  Foot  with  Advanced  Canker.  (Gutenacker)  .  .  .  3i3 
137.  Feet  affected  with  Specific  Coronitis.  (Taylor)  .  .  3z6 
i38.  Fore-foot  with  Specific  Coronitis.  (Taylor)  .  .  .  3zy 
i3g.  Excision  of  the  Lateral  Cartilage    (Old   Method).     . 

(Gutenacker)  ........   3.s3 

140.  Excision    of    the    Lateral    Cartilage.     (After    M oiler    and 

Prick.)      (Gutenacker) 354 


LIST  OF  ILLUSTRATIONS  xxi 

FIG.  PAGE 

141.  Excision     of     the      Lateral      Cartilage,       (After     Buyer.) 
(Gutenacker)      .........  356 

142.  Partial   Excision   of  the  Lateral   Cartilage  .  .  .  362 

143.  Ossified    Lateral    Cartilages,    or    Side-bones  .  .  .   365 

144.  Smith's   Side-bone   Saw   (Old  Pattern)        .  .  .  .3/3 

145.  Smith's   Side-bone   Saw    (Improved    Pattern)      .  .  .   374 

146.  Smith's    Hoof    Plane  .......   3/5 

147.  Hodder's    Hoof    Chisel 375 

148.  Foot  showing  the  Grooves  made  in  Smith's  Operation  for 
Side-bones    (viewed   from   the   Side)  ....   376 

149.  Foot  showing  the  Grooves  made  in  Smith's  Operation  for 
Side-bones    (viewed    from    Below)      .....   3/7 

150.  Periostitis  involving  the  Pedal  and  Navicular  Bones.    (Litt)   3go 

151.  Periostitis  involving  the  Pedal  and  Navicular  Bones.   (Litt)  3qi 

152.  Effects  of  Periostitis  on  the  Os  Pedis.     (Smith)         .  .   392 

153.  Effects  of  Periostitis  on  the  Os  Pedis.     (Smith)  .  .  3g3 

154.  Effects  of  Periostitis  on  the  Os  Pedis.     (Jones)  .  .   394 

155.  Effects  of  Periostitis  on  the  Os  Pedis.     (Jones)         .  .  395 

156.  Case   of  Buttress  Foot.     (Routledge)  ....   399 

157.  Foot  showing  Fracture  of  the  Pyramidal  Process  in  a  Case 

of    Buttress    Foot.     (Routledge)  .....  400 

158.  Fracture  of  the  Os   Coronas.     (Crawford)  .  .  .  404 

159.  Fracture  of  the   Os  Coronse.     (Crawford)  .         .  .  405 

160.  Fractured  Os   Pedis.     (Freeman)        .....  407 

161.  Navicular    Bone    showing    Lesions    of    Navicular    Disease. 
(Gutenacker)      .    _    .         .         .         .         .         .         .         .  43d 

162.  Foot  with  the  Seat  of  Navicular  Disease  exposed    (show- 
ing  Lesions).      {Gutenacker)      ......    /;3z 

i63.  Navicular  Bone  showing  Lesions  of  Navicular  Disease   (a 

Case  of  Long-standing).    (Gutenacker)       ....  433 

164.  Frog    Seton    Needle 445 

165.  Diagram   showing   Course   of  the   Needle   in   Setoning  the 
Frog 446 


DISEASES  OF  THE  HORSE'S  FOOT 


CHAPTER  I 
INTRODUCTION 

The  importance  of  that  branch  of  veterinary  surgery 
dealing  with  diseases  of  the  horse's  foot  can  hardly  be  over- 
estimated. That  the  animal's  usefulness  is  dependent 
upon  his  possession  of  four  good  feet  is  a  fact  that  has  long 
been  recognised.  Who,  indeed,  is  there  to  be  found  en- 
tirely unacquainted  with  one  or  other  of  such  well-known 
aphorisms  as :  'Whoever  hath  charge  of  a  horse's  foot 
has  the  care  of  his  whole  body' ;  'As  well  a  horse  with  no 
head  as  a  horse  with  no  foot' ;  or  the  perhaps  better  known, 
and  certainly  more  epigrammatic,  'No  foot,  no  horse.' 

Without  taking  these  sayings  literally,  it  will  be  admitted 
by  almost  everyone  that  they  contain  a  vast  amount  of 
actual  truth.  This  allowed,  it  at  once  becomes  clear  that  a 
ready  understanding  of  the  diseases  to  which  the  foot  is 
liable,  the  means  of  holding  them  in  check,  and  the  correct 
methods  of  treating  them  should  figure  largely  in  the 
knowledge  at  the  command  of  the  veterinary  surgeon. 

In  the  very  great  majority  of  instances  the  horse's  ability 
to  perform  labour  is  the  one  thing  that  justifies  his  existence, 
and  to  that  end  the  presence  of  four  good,  sound  feet  is  an 
almost  indispensable  qualification.  And  yet  how  many 
circumstances  do  we  see  tending  to  militate  against  that 
one  essential. 

Even  in  colthood  the  foot,  if  neglected,  may  become 
a   source   of   trouble.     Unless   periodically   examined   and 


2  DISEASES  OF  THE  HORSE'S  FOOT 

properly  trimmed,  its  shape  is  liable  to  serious  alteration. 
From  that  in  which  it  is  best  calculated  to  withstand  the 
effects  of  the  wear  it  will  be  called  upon  to  endure  in  after 
life,  it  may  become  so  changed  for  the  worse  as  to  seriously 
affect  the  animal's  value. 

In  the  matter  of  feeding,  too,  trouble  is  likely  to  ensue. 
Particularly  is  this  the  case  where  the  colt  shows  points 
of  exceptional  merit.  He  is  'got  up'  for  show,  and  the 
feet  are  likely  to  fall  victims  to  the  mismanagement  that 
frequent  exhibition  so  often  carries  with  it.  An  extra 
allowance  of  peas,  beans,  wheat,  or  other  equally  injurious 
food  is  given.  The  result  is  a  severe  attack  of  laminitis, 
and  an  otherwise  valuable  and  promising  colt  is  perma- 
nently ruined. 

Exposed  as  it  is,  too,  to  injury,  the  foot  of  a  young  horse, 
even  at  grass,  is  frequently  the  seat  of  injuries  from  picked 
up  nails,  stakes,  or  other  agents  which,  unless  detected  and 
carefully  treated,  may  terminate  in  a  troublesome  case  of 
quittor  and  incurable  lameness. 

With  the  passing  of  colthood,  and  the  coming  into  effect 
of  the  evils  of  further  domestication,  the  troubles  to  which 
the  foot  is  open  become  more  numerous.  Foremost  among 
them  will  come  those  having  their  starting-point  in  errors 
of  practice  originating  in  the  forge ;  for,  in  spite  of  attempts 
at  their  education,  smiths,  as  a  class,  are  yet  grievously 
unversed  in  even  the  elementary  knowledge  of  the  delicate 
construction  of  the  member  that  is  entrusted  to  their  care. 

This  fact  has  been  dilated  on  in  books  devoted  to  shoeing, 
and  in  the  prefatory  note  to  the  last  edition  of  Fleming's 
manual  on  this  subject  we  find  the  following  statement: 
'The  records  of  all  humane  societies  show  that,  of  prosecu- 
tions for  cruelty  to  animals,  an  overwhelming  majority 
refer  to  the  horse ;  and  of  these,  a  large  proportion  are  for 
working  horses  while  suffering  from  lameness  in  one  form 
or  other. 

'  So  frequent  are  such  cases  that  observers  have  concluded 
that  their  prevalence  must  result  from  some  specific  cause, 
and,  not  unnaturally,  attention  has  thus  been  directed  to 


INTRODUCTION 

the  various  modes  of  management  practised  in  relation  to 
the  horse's  foot,  to  the  manner  of  shoeing,  and,  in  particular, 
to  the  way  in  which  the  foot  is  prepared  for  the  shoe.' 

It  must  he  remembered,  however,  that  although  harm  in 
the  forge  may  frequently  arise  from  culpable  roughness 
or  carelessness,  such  is  not  necessarily  always  the  case,  and 
that  quite  as  much  injury  may  result  from  careful  and 
conscientious  workmanship  when  it  is  unfortunate  enough 
to  be  based  upon  principles  wrong  in  themselves  to  com- 
mence with. 

It  so  happens,  too,  that  shoeing,  in  itself  a  necessary 
evil,  may  be  responsible  for  injuries  in  the  causation  of 
which  the  smith  can  have  played  no  part.  Take,  for 
example,  the  ill  effects  following  upon  the  animal's  atten- 
dant allowing  him  to  carry  his  shoes  for  too  long  a  time. 
In  this  case  the  natural  growth  of  the  horn  carries  the  heel 
of  the  shoe  further  beneath  the  foot  than  is  safe  for  a  cor- 
rect bearing;  in  fact,  anterior  to  the  point  of  inflection  of 
the  wall.  The  shoe,  at  the  same  time,  is  greatly  thinned 
from  excessive  wear.  Result,  a  sharp  and  easily-bended 
piece  of  iron  situate  immediately  under  the  seat  of  corn. 
Pressure  of  actual  cutting  of  the  sole  is  bound  to  occur,  and 
the  animal  is  lamed. 

Again,  apart  from  the  question  of  negligence  or  otherwise 
on  the  part  of  the  smith  or  the  animal's  attendant,  it  must 
be  remembered  that  the  nailing  on  to  the  foot  of  a  plate  of 
iron  is  not  giving  to  the  animal  an  easier  means  of  progres- 
sion. The  reverse  is  the  case.  In  place  of  the  sucker-like 
face  of  the  natural  horn  is  substituted  a  smooth,  and,  with 
wear,  highly-polished  surface.  Slipping  and  sliding  at- 
tempts to  gain  a  foothold  become  frequent,  and  strains  of 
the  tendons  and  ligaments  follow  in  their  wake. 

As,  however,  this  treatise  is  not  intended  to  deal  with 
the  art  of  shoeing,  the  reader  must  be  referred  to  other 
works  for  further  information.  In  addition  to  Fleming's, 
there  may  be  mentioned,  among  others.  Hunting's  '  Art  of 
Horse  Shoeing,'  and  the  very  excellent  volume  of  Messrs. 
Dollar  and  YYheatlev  on  the  same  subject. 


4  DISEASES  OF  THE  HORSE'S  FOOT 

Leaving  the  forge,  we  may  next  look  to  the  nature  of  the 
animal's  work,  and  the  conditions  under  which  he  is  kept, 
for  active  causes  in  the  production  of  disorders  of  the  foot. 
From  the  yielding  softness  of  the  pasture  he  is  called  to 
spend  the  bulk  of  his  time  upon  the  hard  macadamized 
tracks  of  our  country  roads,  or  the  still  more  hard  and 
more  dangerous  asphalt  pavings  or  granite  sets  of  our 
towns.  The  former,  with  the  bruises  they  will  give  the 
sole  and  frog  from  loose  and  scattered  stones,  and  the 
latter,  with  the  increased  concussion  they  will  entail  on 
the  limb,  are  active  factors  in  the  troubles  with  which  wg 
are  about  to  deal.  Upon  these  unyielding  surfaces  the 
horse  is  called  to  carry  slowly  or  rapidly,  as  the  case  may 
be,  not  only  his  own  weight,  but,  in  addition,  is  asked  to 
labour  at  the  hauling  of  heavy  loads.  The  effects  of  con- 
cussion and  heavy  traction  combined  are  bound  primarily 
to  find  the  feet,  and  such  diseases  as  sidebones,  ring- 
bones, corns,  and  sandcracks  commence  to  make  their 
appearance. 

Again,  as  opposed  to  the  comparative  healthiness  of  the 
surroundings  when  at  grass,  consideration  must  be  given 
to  the  chemical  changes  the  foot  is  frequently  subjected  to 
when  the  animal  is  housed. 

Only  too  often  the  bedding  the  animal  has  to  stand  upon 
for  several  hours  of  the  twenty-four  can  only  be  fitly 
described  as  '  filthy  in  the  extreme.'  The  ammoniacal 
exhalations  from  these  collected  body-discharges  must, 
and  do,  have  a  prejudicial  effect  upon  the  nature  of  the 
horn,  and,  though  slow  in  its  progress,  mischief  is  bound 
sooner  or  later  to  occur  in  the  shape  of  a  weakened  and 
discharging  frog,  with  its  concomitant  of  contracted  heels. 
Luckily  it  is  in  such  a  case  if  canker  does  not  follow  on. 

Observers,  too,  have  chronicled  the  occurrence  in  horse's 
feet  of  disease  resulting  from  the  use  of  moss  litter. 
Tenderness  in  the  foot  is  first  noticeable,  which  tenderness 
is  afterwards  followed  by  a  peculiar  softening  of  the  horn 
of  the  sole  and  the  frog.  What  should  be  a  dense,  fairly 
resilient  substance  is  transformed  into  a  material  affording 


INTRODUCTION  5 

a  yielding  sensation  to  the  fingers  not  unlike  that  imparted 
by  a  soft  indiarubber,  and  as  easily  sliced  as  cheese-rind. 

Lastly,  though  the  foot  is  extremely  liable  to  suffer  from 
the  effects  of  extreme  dryness  or  excessive  humidity, 
especially  with  regard  to  the  changes  thus  brought  about 
in  the  nature  of  the  horn,  it  is  perforce  exposed  at  all  times 
to  the  varying  condition  of  the  roads  upon  which  it  must 
travel.  The  intense  dryness  of  summer  and  the  constant 
damp  of  winter,  each  in  their  turn  take  part  in  the 
deteriorating  influences  at  work  upon  it. 

Though  this  subject  might  be  indefinitely  prolonged,  this 
brief  resume  of  the  adverse  circumstances  to  which  the 
foot  of  the  horse  is  exposed  is  sufficient  to  point  out  the 
extreme  importance  of  its  study  to  the  veterinary  surgeon. 
So  long  as  the  horse  is  used  as  a  beast  of  burden  so  long 
will  this  branch  of  veterinary  surgery  offer  a  wide  and 
remunerative  field  of  labour. 


CIIAPTEE  11 

REGIONAL  ANATOMY 

Considered  from  a  zoological  standpoint,  the  foot  of  the 
horse  will  include  all  those  parts  from  the  knee  and  hock 
downwards.  For  the  purposes  of  this  treatise,  however,  the 
word  foot  will  be  used  in  its  more  popular  sense,  and  will 
refer  solely  to  those  portions  of  the  digit  contained  within 
the  hoof.  When,  in  this  chapter  on  regional  anatomy,  or 
elsewhere,  the  descriptive  matter  or  the  illustrations  exceed 
that  limit,  it  will  be  with  the  object  of  observing  the 
relationship  between  the  parts  we  are  concerned  with  and 
adjoining  structures. 

Taking  the  limit  we  have  set,  and  enumerating  the  parts 
within  the  hoof  from  within  outwards,  we  find  them  as 
follows : 

A.  The  Bones. — The  lower  portion  of  the  second  phalanx 
or  os  corona? ;  the  third  phalanx,  os  pedis,  or  coffin  bone ; 
and  the  navicular  or  shuttle  bone. 

B.  The  Ligaments. — The  ligaments  binding  the  articu- 
lation. 

C.  The  Tendons. — The  terminal  portions  of  the  exten- 
sor pedis  and  the  flexor  perforans. 

D.  The  Arteries. 

E.  The  Veins. 

F.  The  Nerves. 

G.  The  Complementary  Apparatus  oe  the  Os  Pedis. 
H.  The  Keratogenous  Membrane. 

I.    The  Hoof.  r 


REGIONAL  ANATOMY. 


A.  THE  BOXES. 

The  Second  Pii  \lanx.  ( )s  Coronae,  or  Small  Pastern 
Bone. — This  belongs  to  the  class  of  small  bones,  in  that  it 
possesses  no  medullary  canal.  It  is  situated  obliquely  in 
the  digit,  running  from  above  downwards  and  from  behind 


Fig.  1.— The  Bones  of  the  Phalanx. 

i,  The  os  suffraginis ;  2,  the  os  coronae;  3,  the  os  pedis;  4,  the 
navicular  bone,  hidden  by  the  wing  of  the  os  pedis,  is  in 
articulation   in  the  position  indicated   by  the  barbed  line. 

to  before,  and  articulating  superiorly  w  ith  the  first  phalanx 
or  os  suffraginis,  and  inferiorly  with  the  third  phalanx  and 
the  navicular  bone. 

Cubical  in  shape,  it  is  flattened  from  before  to  behind, 
and    may    be    described    as    possessing    six    surfaces:     An 


DISEASES  OF  THE  HORSE'S  FOOT 


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'■"  "-HPT  J 

wt 

'  if     ^fte- 

■Hi  :"'""'" 

-  w  B| 

.•'      .^" 

Fig.  2.— Second  Phalanx  or  Os  Coronae  (Anterior  View). 

i,   Anterior    surface;    2,    superior    articulatory   surface;    3,   inferior 
articulatory  surface;  4,  pits  for  ligamentous  attachment. 


•psa*"*-  '^^^^HSdJ. 

,  •  W  S 

B5^  ^JfHf-J.  j  ^      ^^J 

Bfefe^-" 

RBF    ■         \.:v<' 

i^B 

K^v^.f;>'- 

B#  --•          ^-^ 

■l^^te'           1 

■La.-             uj^k 

Fig.  3. — Second   Phalanx   or   Os   Coronae   (Posterior  View). 

1,   Posterior  surface;   2,   gliding   surface    for  passage  of   flexor 
perforans ;    3,    lower   articulatory   surface. 


anterior  surface,  covered  with  slight  imprints;  a  posterior 
surface,    provided    above    with    a    transversely    elongated 


REGIONAL  ANATOMY  9 

gliding  surface  for  the  passage  of  the  flexor  perforans ; 
Uvo  lateral  surfaces,  each  rough  and  perforated  by  fora- 
mina?, and  each  bearing  on  its  lower  portion  a  thumb-like 
imprint  for  ligamentous  attachment,  and  for  the  insertion  of 
the  bifid  extremity  of  the  perforatus  tendon ;  a  superior 
surface,  bearing  two  shallow  articular  cavities,  separated  by 
an  anterior-posterior  ridge,  for  the  accommodation  of  the 
lower  articulating  surface  of  the  first  phalanx ;  an  inferior 
surface,  also  articulatory,  which  in  shape  is  obverse  to  the 
superior,  bearing  two  unequal  condyles,  separated  by  an  ill- 
defined  antero-posterior  groove,  which  surface  articulates 
with  the  os  pedis  and  the  navicular  bone. 

Development. — The  bone  usually  ossifies  from  one  centre, 
but  often  there  is  a  complementary  nucleus  for  the  upper 
surface. 

The  Third  Phalanx,  Os  Pedis,  or  Coffin  Bone. — This 
also  belongs  to  the  class  of  short  bones.  It  forms  the 
termination  of  the  digit,  and,  with  the  navicular  bone,  is 
included  entirely  within  the  hoof.  For  our  examination  it 
offers  three  surfaces,  two  lateral  angles,  and  three  edges. 

The  Anterior  or  Laminal  Surface,  following  closely  in 
contour  the  wall  of  the  hoof,  is  markedly  convex  from  side 
to  side,  nearly  straight  from  above  to  below,  and  closely 
dotted  with  foramina?  of  varying  sizes.  On  each  side  of 
this  surface  is  to  be  seen  a  distinct  groove,  the  pre  plantar 
groove,  or  pre  plantar  fissure,  which,  commencing  behind, 
between  the  basilar  and  retrossal  processes,  runs  hori- 
zontally forwards  from  the  angles  or  wings  of  the  bone,  and 
terminates  anteriorly  in  one  of  the  larger  foramina?.  As 
the  name  '  laminal  '  indicates,  it  is  this  surface  which  in 
the  fresh  state  is  covered  by  a  sensitive  lamina?. 

The  Inferior  or  Plantar  Surface,  hollowed  in  the  form  of 
a  low  arch,  presents  for  our  inspection  two  regions,  an 
anterior  and  a  posterior,  divided  by  a  well-marked  line,  the 
Semilunar  Crest,  which  extends  forward  in  the  shape  of  a 
semicircle.  The  anterior  region,  as  is  the  laminal  surface, 
is  covered  with  foramina? ;  in  this  case  more  minute.  In 
the  recent  state  it  is  covered  bv  the  sensitive  sole.     The 


10  DISEASES  OF  THE  HORSE'S  FOOT 

posterior  region,  lying  immediately  behind  the  semilunar 
crest,  shows  on  each  side  of  a  median  process  a  large 
foramen,  the  Plantar  Foramen.  From  this  foramen  runs 
the  Plantar  Groove,  a  channel,  bounded  above  by  the 
superior  edge,  and  below  by  the  semilunar  crest  of  the 
bone,  which  conducts  the  plantar  arteries  into  the  Semi- 
lunar Sinus,  a  well-marked  cavity  in  the  interior  of  the  bone. 

The  Superior  or  Articular  Surface  consists  of  two  shal- 
low depressions,  divided  by  a  slight  median  ridge.  Its 
posterior  part  shows  a  transversely  elongated  facet  for 
articulation  with  the  navicular  bone. 

The  Superior  Edge,  outlining  the  superior  margin  of  the 
laminal  surface,  describes  a  curve,  with  the  convexity  of 
the  curve  forward.  In  the  centre  of  the  curve  is  a  tri- 
angular process,  the  Pyramidal  Process,  which  serves  as 
the  point  of  attachment  of  the  extensor  pedis. 

The  Inferior  Edge,  the  most  extensive  of  the  three, 
separates  the  laminal  from  the  solar  surface.  It  is  semi- 
circular in  shape,  sharp,  and  finely  dentated,  and  is  per- 
forated by  eight  to  ten  large  foraminae. 

The  Posterior  Edge,  very  slightly  concave,  divides  the 
small,  transversely  elongated  facet  of  the  superior  surface 
from  the  posterior  region  of  the  inferior  surface. 

The  Lateral  Angles  of  the  bone,  also  termed  the  Wings, 
are  two  projections  directed  backwards.  Each  is  divided 
b\  a  cleft  into  an  upper,  the  Basilar  Process,  and  a  lower, 
the  Retrossal  Process.  In  old  animals  the  posterior  portion 
of  the  cleft  separating  the  two  processes  gradually  becomes 
filled  in  with  bony  deposit,  thus  transforming  the  cleft  into 
a  foramen,  which  gives  passage  to  the  preplantar  artery. 
We  may  mention  in  passing  that  the  lateral  angles  give 
attachment  to  the  lateral  fibro-cartilages,  and  that  the 
lateral  angles  themselves  in  old  horses  become  increased 
in  size  owing  to  ossification  of  portions  of  the  adjacent 
lateral  cartilages. 

Development. — The  os  pedis  ossifies  from  two  centres, 
one  of  which  is  for  the  articular  surface  ;  but  this  epiphysis 
fuses  with  the  rest  of  the  bone  before  birth. 


REGIONAL  ANATOMY 


11 


Mi  MM 

»T*sP^^^^^r  J v       ' 

HHr 

|S 

■^fe7 -V^^^Ss.                     ""      Aa,^ 

^■F                       i      1   ri 

..1 

t  — 

72HI 

Fig.  4.— Third  Phalanx  or  Os  Pedis  (Postero-lateral  View). 

i.  Anterior  or  laminal  surface;  2,  preplantar  foramen  3,  preplantar 
groove  4,  basilar  process  of  the  wing:  5,  retrossal  process  of  the 
wing ;  6.  foramen  caused  by  the  ossifying  together  posteriorly  of 
the  basilar  and  retrossal  processes. 


Fig.  5. — Third  Phalanx  or  Os  Pedis   (viewed  from  Below). 
1,  Plantar  surface;  2,  plantar  foramen  and  plantar  groove;  3,  semi- 
lunar  crest ;   4,   tendinous   surface ;   5.   retrossal  process   of  the 
wings. 


12  DISEASES  OF  THE  HORSE'S  FOOT 

The  Navicular  Bone,  Shuttle  Bone,  or  Small  Sesa- 
moid.— Placed  behind  the  articulating  point  of  the  second 
and  third  phalanges,  this  small  shuttle-shaped  bone  assists 
in  the  formation  of  the  pedal  articulation.  It  is  elongated 
transversely,  flattened  from  above  to  below,  and  narrow  at 
its  extremities.    In  it  we  see  two  surfaces,  and  two  borders. 

The  Superior  or  Articular  Surface  of  the  bone,  which 
may  easily  be  recognised  by  its  smoothness,  is  moulded  upon 
the  lower  articular  surface  of  the  second  phalanx,  being 
convex  in  its  middle,  and  concave  on  either  side. 

The  Inferior  or  Tendinous  Surface  resembles  the  pre- 
ceding in  form,  but  is  broader  and  less  smooth.  In  the 
recent  state  it  is  covered  with  fibro-cartilage  for  the  passage 
of  the  flexor  perforans. 

The  Anterior  Border  possesses  above  a  small  trans- 
versely elongated  facet  for  articulation  with  the  os  pedis, 
and  below  a  more  extensive  grooved  portion,  perforated  by 
numerous  foramina^,  affording  attachment  to  the  inter- 
osseous ligaments  of  the  articulation. 

The  Posterior  Border,  thick  in  the  middle,  but  thinner 
towards  the  extremities,  is  roughened  for  ligamentous 
attachment. 

Development. — The  bone  ossifies  from  a  single  centre. 

B.  THE    LIGAMENTS. 

The  Articulation  of  the  First  with  the  Second 
Phalanx,  or  the  Pastern  Joint. — Adhering  to  the  limit 
we  have  set,  this  articulation  should  not  receive  our  atten- 
tion. As,  however,  we  shall  in  a  later  page  be  concerned 
with  fractures  of  the  os  coronse,  which  fractures  may  affect 
the  articulation  above  mentioned,  a  brief  note  of  its  forma- 
tion will  not  be  out  of  place. 

It  is  an  imperfect  hinge-joint,  permitting  of  extension  and 
flexion,  allowing  the  first  phalanx  to  pivot  on  the  second, 
and  admitting  of  the  performance  of  slight  lateral  move- 
ments. It  is  formed  by  the  opposing  of  the  inferior  surface 
of  the  os  suffraginis  with  the  superior  surface  of  the  os 
coronse.      The    articulating   surface    of    the   os   coronae   is 


REGIONAL  ANATOMY 


13 


Fig.   6. — The    Navicular   Bone    (viewed   from   Below). 

Inferior  surface  (smooth  for  the  passage  of  the  flexor  perforans)  ; 
2,  anterior  edge  of  inferior  surface;  3,  posterior  edge  of  inferior 
surface. 


Fig.    7. — The   Navicular   Bone    (viewed  from   Above,   the   Bone 
Tilted  Posteriorly  to  show  its  Anterior  Border). 

1,  Superior  articulatory   surface:  2,  anterior  border   (grooved  por- 
tion of)  ;  3,  anterior  border   (articulatory  portion  of). 


14 


DISEASES  OF  THE  HORSE'S  FOOT 


supplemented  by  the  addition  behind  of  a  thick  piece  of 
fibro-cartilage  (the  glenoid)  attached  inferiorly  to  the  pos- 
terior edge  of  the  upper  arti dilatory  surface  of  the  os  cor- 
onse,  and  superiorly  by  means  of  three  fibrous  slips  on  each 
side  to  the  os  suffraginis.     The  innermost  of  these  three 


Fig.  8. — Ligaments  of  the  First  and  Second  Interphalangeal 
Articulations  (viewed  from  the  Side).  (After  Dollar  and 
Wheatley). 

i,  Outermost  slip  from  the  glenoidal  fibro-cartilage;  2,  lateral  liga- 
ment of  the  first  interphalangeal  articulation ;  3,  prolongations 
of  the  lateral  ligament  of  the  first  interphalangeal  articulation 
attached  to  the  end  of  the  navicular  bone  to  form  the  postero- 
lateral ligament  of  the  pedal  joint;  4,  end  of  the  navicular  bone; 
5;  antero-lateral  ligament  of  the  pedal  joint. 


slips  becomes  attached  to  about  the  middle  of  the  lateral 
edge  of  the  suffraginis,  and  the  remaining  two,  beneath  the 
first,  attach  themselves  to  nearer  the  lower  end  of  that  bone. 
The  posterior  surface  of  the  complementary  cartilage  forms 
a  gliding  surface  for  the  passage  of  the  perforans. 


REGIONAL  ANATOMY  15 

The  Lateral  Ligaments. — These  are  large  and  thick,  an 
outer  and  an  inner,  running  obliquely  from  above  down- 
wards and  backwards.  Each  is  inserted  superiorly  into 
the  lateral  tubercle  of  the  lower  end  of  the  first  phalanx, 
and  inferiorly  to  the  side  of  the  second  phalanx,  their  most 
inferior  fibres  becoming  finally  fixed  to  the  extremities  of 
the  navicular  bone,  where  they  form  the  postero-lateral 
ligaments  of  the  pedal  articulation.  In  front  of  the  joint 
the  extensor  pedis  plays  the  part  of  an  additional  ligament. 

The  Synovial  Membrane. — This  is  limited  in  front  by  the 
tendon  of  the  extensor  pedis,  on  each  side  by  the  lateral 
ligaments  of  the  joint,  and  behind  by  the  glenoid  fibro- 
cartilage.  At  this  point  it  is  prolonged  upwards  as  a  pouch 
behind  the  lower  extremity  of  the  first  phalanx. 

The  Articulation  of  the  Second  Phalanx  with  the 
Third,  the  Pedal,  or  the  Coffin  Joint. — This  also  is  an 
imperfect  hinge-joint,  permitting  only  of  flexion  and  exten- 
sion, which  movements  are  more  restricted  than  in  the 
previous  articulation.  Three  bones  enter  into  its  forma- 
tion :  the  second  phalanx,  the  third  phalanx,  and  the 
navicular  bone.  The  lower  articulator}'  surface  is  formed 
by  the  third  phalanx  and  the  navicular  bone  combined. 
To  effect  this  the  navicular  is  closely  and  firmly  attached 
to  the  third  phalanx  by  an  interosseous  ligament.  The 
two  bones,  as  one,  are  than  connected  to  the  second  phalanx 
by  four  lateral  ligaments,  an  anterior  and  a  posterior  on 
each  side. 

The  Interosseous  Ligament  consists  of  extremely  short 
fibres  running  from  the  extensively  grooved  portion  of  the 
anterior  surface  of  the  navicular  bone  to  become  attached 
to  the  os  pedis  immediately  behind  its  articular  surface. 

The  Antero-lateral  Ligaments  are  attached  by  their 
superior  extremities  to  the  lateral  surfaces  of  the  second 
phalanx,  and  by  their  inferior  extremities  into  the  depres- 
sions on  either  side  of  the  pyramidal  process  of  the  o>: 
pedis. 

The  Postero-lateral  Ligaments. — As  mentioned  when 
describing  the   first  interphalangeal  articulation,   these  are 


16 


DISEASES  OF  THE  HORSE'S  FOOT 


in   reality   continuations   of   the   lateral   ligaments    of   that 
joint.     Running  obliquely  downwards  and  backwards  from 


Fig.  9.— Ligaments  of  the  First  and  Second  Interphalangeal 
Articulations  (viewed  from  Behind).  (After  Dollar  and 
Wheatley). 

i,  Suspensory  ligament;  2,  innermost  slip  from  complementary 
cartilage. of  pastern  joint;  3,  middle  slip  from  complementary 
cartilage  of  pastern  joint ;  4,  outermost  slip  from  complementary 
cartilage  of  pastern  joint;  5,  glenoid  or  complementary  cartilage 
of  pastern  joint;  6,  postero-lateral  ligaments  of  the  pedal  joint; 
9,  semilunar  crest  of  os  pedis ;   10,  plantar  surface  of  os  pedis. 


their  point  of  attachment  to  the  first  phalanx  they  curve 
round  the  lower  part  of  the  side  of  the  second  phalanx  and 


REGIONAL  ANATOMY  17 

end  of  the  extremities  and  posterior  surface  of  the  navicular 
bone.  Having  reached  that  position,  they  send  short 
attachments  to  the  retrossal  process  of  the  os  pedis  and  to 
the  inner  face  of  the  lateral  cartilage. 

Synovial  Membrane. — This  extends  below  the  facets 
uniting  the  navicular  to  the  pedal  bone,  and  offers  for 
consideration  two  sacs.  A  large  one  posteriorly  running 
up  behind  the  second  phalanx  to  nearly  adjoin  the  sesa- 
moidean  bursa?,  and  a  small  one,  a  prolongation  of  the 
synovial  membrane  between  the  antero-lateral  and  postero- 
lateral ligaments  of  the  same  side.  This  latter  is  often 
distended,  and  on  account  of  its  close  proximity  to  the  seat 
of  operation,  is  liable  to  be  accidentally  opened  in  excision 
of  the  lateral  cartilage  for  quittor. 

C.  THE    TENDONS. 

In  order  to  convey  an  intelligent  understanding  of  the 
tendons  it  will  be  wise  to  briefly  describe  the  course  of 
their  parent  muscles  from  their  commencement. 

The  Extensor  Pedis. — The  extensor  pedis  arises  from 
the  lower  extremity  of  the  humerus  in  two  distinct  portions 
of  unequal  size,  a  muscular  and  a  tendinous.  These  are 
succeeded  by  two  tendons  passing  in  common  through  a 
vertical  groove  at  the  lower  end  of  the  radius.  Lower  in 
the  limb  these  tendons  separate,  the  outer  and  smaller 
joining  the  tendon  of  the  extensor  suffraginis,  and  the 
inner  and  main  tendon  continuing  its  course  downwards. 
With  the  exception  of  the  navicular,  it  is  attached  to  all  the 
bones  of  the  foot,  and  is  covered  internally  by  the  capsular 
ligaments  of  the  joints  over  which  it  passes,  those  with 
which  we  are  concerned  being  the  pastern  joint  and  the 
pedal  joint.  Before  its  attachment  to  the  os  pedis  it 
receives  on  each  side  of  the  middle  of  the  first  phalanx 
reinforcement  in  the  shape  of  a  strong  band  descending 
obliquely  over  the  fetlock  from  the  suspensory  ligament. 
Widening  out  in  fanlike  fashion,  it  is  inserted  into  the 
pyramidal  process  of  the  os  pedis. 


18 


DISEASES  OF  THE  HORSE'S  FOOT 


Action. — The  action  of  this  muscle  is  to  extend  the  third 
phalanx  on  the  second,  the  second  on  the  first,  and  the  first 
on  the  metacarpus.  It  also  assists  in  the  extension  of  the 
foot  on  the  forearm. 


Fig.  10.— The  Flexor  Tendons  and  Extensor  Pedis. 
(After  Haubner.) 

I,  Tendon  of  flexor  perforans;  2,  its  supporting  check-band  from  the 
posterior  ligament  of  the  carpus ;  3,  tendon  of  the  flexor  per- 
forates ;  4,  ring  and  sheath  of  the  flexor  perf oratus ;  5,  widen- 
ing_  out  the  the  flexor  perf  oratus  to  form  the  plantar  aponeu- 
rosis;  6,  suspensory  ligament;  7,  reinforcing  band  from  the 
suspensory  ligament  to  the  extensor  pedis ;  8,  the  extensor  pedis. 

The  Flexor  Pedis  Perforatus,  or  the  Superficial 
Flexor  of  the  Phalanges. — In  common  with  the  perfo- 
rans, this  muscle  arises  from  the  inner  condyloid  ridge  of 
the  humerus.     It  is  reinforced  at  the  lower  end  of  the  radius 


REGIONAL  ANATOMY 


19 


by  the  superior  carpal  ligament,  passes  through  the  carpal 
and    metacarpophalangeal    sheaths,    and.    arriving    behind 


Fig.   11. — The   Flexor   Perforans   and   Flexor  Perforatus 
Tendons. 

The  metacarpophalangeal  sheath  and  the  ring  of  the  perforatus 
laid  open  posteriorly,  and  the  cut  edges  reflected  to  show  the 
passage  of  the  perforans. 

i.  Reflected  cut  edges  of  the  perforatus  ring  and  the  metacarpo- 
phalangeal sheath  ;  2,  the  perforans  tendon ;  3,  point  of  insertion 
of  the  perforans  tendon  into  the  semilunar  crest  of  the  os  pedis 
(this  widened  and  thickened  extremity  of  the  perforans  is  known 
as  the  plantar  aponeurosis). 

the  fetlock,  forms  a  ring  for  the  passage  of  the  flexor 
perforans.  Its  termination  is  bifid,  and  it  is  inserted  on 
either  side  to  the  lateral  surface  of  the  second  phalanx. 


DISEASES  OF  THE  HORSE'S  FOOT 


Fig.  12. — The  Flexor  Perforates  and  Flexor  Perforans  Tendons. 

The  metacarpophalangeal  sheath  and  the  ring  of  the  perforatus  laid 
open  posteriorly,  and  the  cut  edges  reflected ;  the  flexor  per- 
forans cut  through  at  about  the  region  of  the  sesamoids,  and 
its  inferior  portion  deflected. 

I,  Superior  end  of  severed  perforans  tendon;  2,  inferior  end  of 
severed  perforans  tendon ;  3,  insertion  of  flexor  perforans  into 
semilunar  crest  of  os  pedis;  4,  the  cut  and  reflected  edges  of  the 
metacarpophalangeal  sheath  and  perforatus  ring;  5,  the  bifid 
insertion  of  the  flexor  perforatus  into  the  lateral  surfaces  of  the 
os  coronae;  6,  the  capsular  ligament  of  the  pedal  joint;  7,  the 
navicular  bone ;  8,  the  posterior  surface  and  glenoid  fibro- 
cartilage  of  the  os  corona. 


REGIONAL  ANATOMY 


21 


Action. — This  muscle  flexes  the  second  phalanx  on  the 
first,  the  first  on  the  metacarpus,  and  the  entire  foot  on  the 
forearm.  Mechanically,  it  acts  as  a  stay  when  the  animal 
is  standing  by  maintaining  the  metacarpophalangeal  angle. 

The  Flexor  Pedis  Perforans,  or  the  Deep  Flexor  of 
the  Phalanges. — This  muscle  consists  of  three  easily- 
divided  portions :  an  ulnar,  a  humeral,  and  a  radial,  and  has 


Fig.   13. — Median  Section  of  Foot. 

A,  Os  suffraginis ;  B,  os  coronae;  C,  os  pedis;  D,  navicular  bone; 
E,  tendon  of  the  extensor  pedis ;  F.  insertion  of  the  extensor 
pedis  into  the  pyramidal  process  of  the  os  pedis ;  G,  the  tendon 
of  the  flexor  perforatus ;  H,  insertion  of  perf oratus  into  the  os 
corona?;  /.  tendon  of  the  flexor  perf orans ;  J,  its  passing  attach- 
ment to  the  os  corona? ;  K,  its  final  insertion  in  the  semilunar 
crest  of  os  pedis ;  a,  section  of  coronary  cushion ;  b,  section  of 
plantar  cushion ;  c,  semilunar  sinus  of  os  pedis. 

for  points  of  origin  the  olecranon  process  of  the  ulna,  the 
inner  condyloid  ridge  of  the  humerus,  and  the  posterior  sur- 
face of  the  radius.  These  portions  are  continued  by  a  com- 
mon tendon  which  enters  the  carpal  sheath  with  the  tendon 
of  the  perforatus,  and  continues  with  it  through  the  synovial 


22  DISEASES  OF  THE  HORSE'S  FOOT 

sheath  of  the  metacarpophalangeal  region.  Like  the  last- 
named  tendon,  it  receives  a  supporting  check-band,  in  this 
case  from  the  posterior  ligament  of  the  carpus.  Passing 
down  between  the  suspensory  ligament  in  front,  and  the 
perforatus  tendon  behind,  it  glides  over  the  sesamoid  pulley 
and  passes  through  the  ring  formed  by  the  perforatus. 
Continuing  its  course,  it  passes  between  the  bifurcating 
portions  of  the  extremity  of  the  perforatus,  glides  over  the 
smooth  posterior  surface  of  the  supplementary  glenoid  car- 
tilage of  the  articulation  of  the  first  and  second  phalanges, 
plays  over  the  inferior  surface  of  the  navicular  bone,  and 
finally  becomes  inserted  into  the  semilunar  crest  of  the  os 
pedis.  On  reaching  the  posterior  border  of  the  navicular 
bone  it  widens  out  to  form  the  plantar  aponeurosis. 

In  connection  with  the  lower  portion  of  this  tendon  must 
be  noticed  the  Navicular  Sheath.  This  is  a  synovial  sheath 
lining  the  deep  face  of  the  tendon,  and  reflected  on  to  the 
navicular  bone  and  the  interosseous  ligament  of  the  pedal 
joint.  This  will  be  of  particular  interest  when  we  come  to 
deal  with  cases  of  pricked  foot  from  picked  up  nails. 
Above,  it  is  in  connection  with  the  synovial  membrane  of 
the  pedal  articulation  and  that  of  the  metacarpophalangeal 
sheath. 

Action. — The  action  of  the  perforans  is  to  flex  the  third 
on  the  second,  and  the  second  on  the  first  phalanx.  The 
latter  it  flexes  in  turn  on  the  metacarpus.  It  also  assists 
in  the  flexion  of  the  entire  foot  on  the  forearm,  and  in  sup- 
porting the  angle  of  the  metacarpophalangeal  articulation 
when  the  animal  is  standing. 

D.  THE    ARTERIES. 

So  far  as  the  arteries  supplying  the  foot  are  concerned, 
we  shall  be  interested  in  following  up  the  distribution  of  the 
two  digitals,  which  are  the  terminal  branches  of  the  Large 
Metacarpal. 

The  Large  Metacarpal,  or  Collateral  Artery  of  the 
Cannon. — This,  the  larger  terminal  branch  of  the  posterior 
radial  artery,  needs  brief  mention,  for  the  reason  that  we 


REGIONAL  ANATOMY  23 

shall  be  afterwards  concerned  with  it  in  the  operation  of 
neurectomy.  Its  point  of  origin  is  the  inside  of  the  inferior 
extremity  of  the  radius.  Descending  in  company  with  the 
flexor  tendons,  and  passing  behind  the  carpus  and  beneath 
the  carpal  sheath,  it  continues  its  descent,  in  company  with 
the  internal  plantar  nerve  and  the  internal  metacarpal  vein, 
on  the  inner  side  of  the  flexor  tendons  until  just  above  the 
fetlock.    At  this  point  it  bifurcates  into  the  digital  arteries. 

From  the  carpus  downwards  the  large  metacarpal  artery, 
the  internal  metacarpal  vein,  and  the  internal  plantar  nerve 
are  in  close  relation  with  each  other.  The  vein  holds  the 
anterior  position.  The  artery  is  between  the  two,  and  has 
the  nerve  in  close  contact  with  it  behind. 

The  Digital  Arteries,  or  Collateral  Arteries  of  the 
Digit. — These  are  of  large  volume,  and  carry  the  blood 
to  the  keratogenous  apparatus  of  the  foot.  They  separate 
from  each  other  at  an  acute  angle,  and  pass  over  the  side  of 
the  fetlock,  one  to  the  inside,  the  other  to  the  outside, 
to  reach  the  internal  face  of  the  basilar  process  of  the 
os  pedis,  where  they  bifurcate  to  form  the  Plantar  and 
Preplantar  arteries.  In  the  wdiole  of  their  course  the  digital 
arteries  follow  the  flexor  tendons,  and  are  related  in  front 
to  the  digital  vein,  and  behind  to  the  posterior  branch 
of  the  plantar  nerve.  This  is  the  nerve  implicated  in  the 
lower  operation  of  neurectomy,  and  its  relation  to  adjoining 
structures  will  be  detailed  under  Section  F.  of  this  chapter. 
During  its  course  the  digital  artery  gives  off  branches  in 
the  following  positions : 

1.  At  the  Fetlock  numerous  branches  to  the  metacarpo- 
phalangeal articulation,  the  sesamoid  sheath,  and  the 
tendons. 

2.  At  the  Upper  Extremity  of  the  First  Phalanx  branches 
for  the  supply  of  the  surrounding  tissues,  and  for  the  tissues 
of  the  ergot. 

3.  Towards  the  Middle  of  the  Third  Phalanx,  the  Per- 
pendicular artery  of  Percival.  This  arises  at  a  right  angle 
from  the  main  vessel,  and  immediately  divides  into  two 
series    of    ramifications — an   ascending    and   a    descending. 


24 


DISEASES.  OF  THE  HORSE'S  FOOT 


The  ramifications  of  these  series   freely  anastomose  with 
corresponding  vessels  of  the  opposite  side. 

4.  At  the  Superior  Border  of  the  Lateral  Cartilage,  the 
Artery  of  the  Plantar  Cushion.     This  is  directed  obliquely 


Fig.  14. — The  Arteries  of  the  Foot. 

i,  The  digital;  2,  the  perpendicular — (a)  its  ascending  branch,  (b) 
its  descending  branch ;  3,  circumflex  artery  of  coronary  cushion ; 
4,  the  preplantar  (ungual)  artery— this  is  seen  issuing  from  the 
preplantar  foramen,  and  distributing  numerous  ascending  (c) 
and  descending  (d)  branches  (the  latter  concur  in  forming  the 
circumflex  artery  of  the  toe)  ;  5,  the  circumflex  artery  of  the 
toe;  6,  at  the  point  marked  (*)  the  terminal  branch  of  the 
digital — namely,  the  plantar  ungual — is  hidden  behind  the  lateral 
cartilage ;  7,  the  lateral  cartilage. 

downwards  and  backwards,  under  cover  of  the  cartilage, 
and  is  distributed  to  the  middle  portion  of  the  comple- 
mentary apparatus  of  the  os  pedis,  as  well  as  to  the  villous 
tissue  and  the  coronet.     A  branch  of  it  is  turned  forwards 


REGIONAL  ANATOMY  25 

to  join  with  the  coronary  circle  in  forming  the  circumflex 
artery  of  the  coronet. 

5.  Under  the  Lateral  Cartilage  two  transverse  branches, 
an  anterior  and  a  posterior,  to  form  the  Coronary  Circle. 
The  numerous  ramifications  of  these  branches  anastomose 
both  anteriorly  and  posteriorly  with  their  corresponding 
branches  of  the  artery  of  the  opposite  side.  This  circle 
closely  embraces  the  os  coronae.  Among  the  larger  branches 
given  off  from  its  anterior  portion  are  two  descending,  one 
on  each  side  of  the  extensor  pedis,  to  assist  in  the  formation 
of  the  Circumflex  Artery  of  the  Coronary  Cushion.  The 
formation  of  this  last  named  artery  is  completed  posteriorly 
by  the  before-mentioned  branch  from  the  artery  of  the 
plantar  cushion. 

The  Preplaxtar  (Ungual*)  Artery. — This,  the  smaller 
of  the  two  terminal  branches  of  the  digital,  is  situated 
inside  the  basilar  process  of  the  os  pedis.  It  turns  round 
this  to  gain  the  fissure  between  the  basilar  and  retrossal 
processes,  and  becomes  lodged  in  the  preplantar  fissure. 
Here  it  terminates  in  several  divisions  which  bury  them- 
selves in  the  os  pedis.  Before  leaving  the  inner  aspect  of 
the  pedal  wing  it  supplies  a  deep  branch  to  the  heel  and 
the  vilous  tissue.  Gaining  the  outer  aspect  of  the  wing. 
it  distributes  a  further  backward  branch,  which  passes 
behind  the  circumflex  artery  of  the  pedal  bone,  and,  during 
its  passage  in  the  perplantar  fissure,  gives  off  ascending  and 
descending  branches,  which  ramify  in  the  laminal  tissue. 

The  Plaxtar  (Ungual*)  Artery. — This,  the  larger  of 
the  two  terminals  of  the  digital,  may  be  looked  upon  as 
a  continuation  of  the  main  vessel.  Running  along  the 
plantar  groove,  it  gains  the  plantar  foramen.  Here  it 
enters  the  interior  of  the  bone  (the  semilunar  sinus)  and 
anastomoses  with  the  corresponding  artery  of  the  opposite 
side.  The  circle  of  vessels  so  formed  is  called  the  Plantar 
Arch  or  the  Semilunar  Anastomosis. 

*  The  epithet  'ungual'  is  added  by  Chauveau  to  distinguish  these 
arteries  from  the  properly  so-called  plantar  arteries — the  terminal 
divisions  of  the  posterior  tibial  artery. 


26  DISEASES  OF  THE  HORSE'S  FOOT 

From  the  semilunar  anastomosis  radiate  two  main 
groups  of  arterial  branches,  an  ascending  group  and  a 
descending  one.  The  ascending  branches  penetrate  the 
substance  of  the  os  pedis,  and  emerge  by  the  numerous 
foraminae  on  its  laminal  surface.  The  descending  branches, 
larger  in  size,  also  penetrate  the  substance  of  the  pedal 
bone,  and  emerge  in  turn  from  the  foraminae  cribbling  its 
outer  surface — in  this  case  the  set  of  larger  foraminse 
opening  on  its  inferior  edge.  Having  gained  exit  from  the 
bone,  their  frequent  anastomosis,  right  and  left,  with  their 
fellows  forms  a  large  vessel  following  the  contour  of  the 
inferior  edge  of  the  os  pedis.  This  constitutes  the  Circum- 
flex Artery  of  the  Toe. 


E.  THE  VEINS. 

These  commence  at  the  foot  with  a  series  of  plexuses, 
which  may  be  described  as  forming  (  1  )  An  Internal,  or 
Intra-osseous  Venous  System,  and  (2)  An  External  or 
Extra-osseous  Venous  System. 

1.  The  Intra-osseous  Venous  System. — This  is  a  venous 
system  within  the  structure  of,  and  occupying  the  semi- 
lunar sinus  of  the  os  pedis.  It  follows  in  every  respect  the 
arrangement  of  the  arteries  as  before  described  in  the  same 
region.  Efferent  vessels  emerge  from  the  plantar  foraminse, 
follow  the  plantar  fissures,  and  ascend  within  the  basilar 
processes  of  the  os  pedis.  Here  they  lie  under  shelter  of 
the  lateral  cartilages,  and  assist  in  the  formation  of  the 
deep  layer  of  the  coronary  plexus  of  the  extra-osseous 
system. 

2.  The  Extra-osseous  Venous  System. — This  may  be 
regarded  as  a  close-meshed  network  enveloping  the  whole 
of  the  foot.  Although  a  continuous  system,  it  is  best 
described  by  recognising  in  it  three  distinct  parts : 

(a)  The  Solar  Plexus. 

(b)  The  Podophyllous  Plexus. 

(c)  The  Coronary  Plexus. 


REGIONAL  AX.Vn  )MY  27 

(a)  The  Solar  Plexus. — The  veins  of  this  plexus  dis- 
charge themselves  in  two  directions:  (  1  )  By  a  central  canal 
or  canals  running  along  the  bottom  of  the  lateral  lacunae 
of  the  plantar  cushion  to  gain  the  deep  layer  of  the  coronary 
plexus.  (2)  By  the  Circumflex  or  Peripheral  Vein  of  the 
Toe,  a  canal  formed  by  ramifications  from  the  solar  and  the 
podophyllous  plexuses,  and  following  the  direction  of  the 
artery  of  the  same  name.  The  circumflex  vein  terminates 
by  forwarding  branches  to  concur  in  the  formation  of  the 
superficial  coronary  plexus. 

(b)  The  Podophyllous  or  Luminal  Plexus. — The  podo- 
phyllous veins  anastomose  below  with  the  circumflex  vein 
of  the  solar  plexus,  and  above  with  the  veins  of  the 
coronary  plexus. 

( e)  The  Coronary  Plexus. — This  proceeds  from  the  podo- 
phyllous, the  intra-osseous,  and  the  solar  networks,  and 
consists  of  a  central  and  tzvo  lateral  parts. 

The  central  portion  lies  between  the  lateral  cartilages 
and  immediately  under  the  coronary  cushion.  The  lateral 
portions  are  ramifications  on  both  surfaces  of  the  lateral 
cartilages.  The  ramifications  on  the  lateral  cartilages 
may  be  again  distinguished  as  superficial  and  deep.  The 
superficial  layer  is  distributed  over  the  external  face  of  the 
cartilage,  forming  thereon  a  dense  network,  and  finally 
converges  towards  the  superior  limit  of  the  plexus  to  form 
ten  or  twelve  principal  branches,  which  again  unite  to 
form  two  large  vessels.  These  vessels,  by  their  final  fusion 
at  the  lower  end  of  the  first  phalanx,  constitute  the  digital 
\ein.  The  deep  layer  is  formed,  as  before  described,  by 
ascending  branches  from  the  posterior  parts  of  the  podo- 
phyllous and  solar  plexuses,  and  by  branches  from  the 
intra-osseous  system  of  the  pedal  bone.  The  veins  of  this 
deep  layer  finally  drain  into  the  two  vessels  proceeding 
from  the  superficial  layer,  which  go  to  the  formation  of  the 
digital   vein. 

The  Digital  Veins. — These  arise  from  the  network 
formed  on  the  surfaces  of  the  lateral  cartilages,  and  ascend 
in  front  of  the  digital  arteries  to  unite  above  the  fetlock, 


28  DISEASES  OF  THE  HORSE'S  FOOT 

where  they  form  an  arch  between  the  deep  flexor  and  the 
suspensory  ligament.  From  this  arch  (named  the  Sesa- 
m  old  can)  proceed  the  Metacarpal  Veins. 

The  Metacarpal  Veins. — Three  in  number,  they  are 
distinguished  as  an  Internal  and  an  External  Metacarpal, 
and  a  Deep  or  Interosseous  Metacarpal.  As  we  shall  be 
concerned  with  these  in  the  higher  operation  of  neurectomy, 
we  may  give  them  brief  mention. 

The  Internal  Metacarpal  Vein,  the  largest  of  the 
three,  has  relations  with  the  internal  metacarpal  artery  and 
the  internal  plantar  nerve.  These  relations  were  shortly 
discussed  under  the  section  devoted  to  the  arteries,  to  which 
the  reader  may  refer. 

The  External  Metacarpal  Vein. — This  ascends  on  the 
external  side  of  the  flexor  tendons  in  company  with  the 
external  plantar  nerve. 

The  Interosseous  Vein. — This  is  an  irregular  vessel  run- 
ning up  between  the  suspensory  ligament  and  the  posterior 
face  of  the  large  metacarpal  bone. 

F.    THE  NERVES. 

The  Plantar  Nerves.— These  are  two  in  number,  and 
are  distinguished  as  Internal  and  External. 

The  Internal  Plantar  Nerve  lies  behind  and  in  close 
contact  with  the  great  metacarpal  artery  during  that  vessel's 
course  down  the  region  of  the  cannon.  A  point  of  interest 
is  that  it  gives  off  at  about  the  middle  of  the  cannon  a 
branch  which  bends  obliquely  downwards  and  behind  the 
flexor  tendons  to  join  its  fellow  of  the  opposite  side — 
namely,  the  external  plantar.  This  it  joins  an  inch  or 
more  above  the  bottom  of  the  splint  bone.  Measured  in  a 
straight  line,  this  is  about  2\  inches  below  its  point  of 
origin.  Near  the  fetlock,  at  the  level  of  the  sesamoids,  the 
internal  plantar  nerve  ends  in  several  digital  branches. 

The  External  Plantar  Nerve. — This  holds  a  position 
to  the  outside  of  the  metacarpal  region,  analogous  to  that 
of  the  internal  plantar  nerve  on  the  inside  of  the  limb, 
running  down  on  the  external  edge  of  the  flexor  tendons. 


REGIONAL  ANATOMY 


29 


Unlike  the  internal  nerve,  it  is  accompanied  by  a  single 
vessel  only,  the  external  metacarpal  vein,  behind  which  it 
lies.  At  the  level  of  the  sesamoid  bones  it  divides,  as  does 
the  internal  nerve,  into  three  main  branches — the  digital 
nerves. 


Fig.   15. — The  Veins  and  Nerves  of  the  Foot. 

i.  The  digital  vein;  2,  its  main  tributaries,  draining  the  podophyllous 
plexus,  and  concurring  to  form  the  digital ;  3,  the  digital  artery 
(the  main  trunk  only  of  this  is  shown,  in  order  to  show  its 
relationship  with  the  vein  and  nerve)  ;  4,  the  plantar  nerve,  with 
its  three  branches — (a)  the  anterior  digital,  ( b )  the  middle 
digital,  ( c)  the  posterior  digital;  5,  the  podophyllous  plexus; 
6,  superficial  portion  of  the  coronary  plexus  ;  J,  the  peripheral 
or  circumflex  vein  of  the  toe. 


The  Digital  Nerves. — These  are  distinguished  as 
Anterior,  Middle,  and  Posterior. 

The  .-Interior  Branch  descends  in  front  of  the  vein,  dis- 
tributing cutaneous  branches  to  the  front  of  the  digit,  and 
terminating  in  the  coronary  cushion. 


30  DISEASES  OE  THE  HORSE'S  FOOT 

The  Middle  Branch  descends  between  the  artery  and  the 
vein,  and  freely  anastomoses  with  the  two  other  branches. 
It  terminates  in  the  coronary  cushion  and  the  sensitive 
laminse. 

The  Posterior  Branch. — This  is  the  largest  of  the  three, 
and  may  be  regarded  as  the  direct  continuation  of  the 
plantar.  At  the  fetlock  it  is  placed  immediately  above  the 
digital  artery,  but  afterwards  takes  up  a  position  directly 
behind  that  vessel.  Together  with  the  digital  artery  it 
descends  to  near  the  basilar  process  of  the  os  pedis.  Here 
it  passes  with  the  plantar  artery  into  the  interior  of  the 
os  pedis,  and  continues  its  main  branch,  with  the  pre- 
plantar  artery,  in  the  fissure  of  the  same  name,  to  finally 
furnish  supply  to  the  os  pedis  and  the  sensitive  laminse. 
It  is  this  nerve  which  is  divided  in  the  low  operation  of 
neurectomy. 

Beyond  the  fact  of  this  branch  descending,  in  the 
region  of  the  pastern,  ^  inch  behind  the  digital  artery,  a 
further  point  of  interest  presents  itself  to  the  surgeon,  and 
one  to  which  attention  must  be  paid.  This  is  the  presence 
in  close  proximity  to  the  nerve  of  the  Ligament  of  the  Pad 
(Per rival),  or  the  Ligament  of  the  Ergot  (McFadyean). 
This  is  a  subcutaneous  glistening  cord  originating  in  the 
ergot  of  the  fetlock,  passing  in  an  oblique  direction  down- 
wards and  forwards,  and  crossing  over  on  its  way  both 
the  digital  artery  and  the  posterior  branch  of  the  digital 
nerve. 

In  the  foregoing  description  of  the  anatomy,  we  have 
taken  the  fore-limb  as  our  guide.  In  the  hind-limb,  where 
they  reach  the  foot,  the  counterparts  of  the  tendons, 
arteries,  veins,  and  nerves  differ  in  no  great  essential  from 
their  fellow  in  the  fore.  They  will  therefore  need  no 
special  mention. 

G  THE  COMPLEMENTARY  APPARATUS  OF  THE  OS  PEDIS. 

This  consists  of  two  lateral  pieces,  the  Lateral  Carti- 
lages or  Fibro-cartilages  of  the  pedal  bone,  united  behind 
and  below  by  the  Plantar  Cushion. 


REGTOXAL  ANATOMY 


31 


a  flattened  plate 
^orders  separated 


1.     The  Lateral  Cartilages. — Each  ii 
of  cartilage,  possessing  two  faces  and  four  in 
by  four  angles. 

The  external  face  is  convex,  covered  by  a  plexus  of  veins, 
and  slightly  overhangs  the  pedal  bone.  The  internal  face 
is  concave,  and  covers  in  front  the  pedal  articulation  and 
the  synovial  sac,  already  mentioned  as  protruding  between 
the  antero-  and  postero-lateral  ligaments  of  that  joint.  We 
have  already  remarked  that  this  is  a  point  of  interest  to  be 


w&  JJBS&, 

B      --ii 

Fig.  16. — External  Face  of  the  Outer  Lateral  Cartilage. 

i,  External  face  of  cartilage — (a)  its  upper  border,  (70,  its  posterior 
border,  (r)  its  anterior  border,  (d)  its  inferior  border;  2,  the 
os  pedis ;  3.  wing  of  os  pedis. 


remembered  in  connection  with  the  operation  for  quittor. 
Below  and  behind,  the  internal  face  of  the  cartilage  is 
united  to  the  plantar  cushion. 

The  upper  border,  sometimes  convex,  sometimes  straight. 
is  thin  and  bevelled,  and  may  easily  be  felt  in  the  living 
animal.  It  is  this  border  that  the  digital  vessels  cross  to 
gain  the  foot,  and  the  border  is  often  broken  by  a  deep 
notch  to  accommodate  them.  The  inferior  border  is 
attached   in    front   to   the  basilar   and   retrossal   processes, 


32  DISEASES  OF  THE  HORSE'S  FOOT 

behind  which  it  blends  with  the  plantar  cushion.  The 
posterior  border  is  oblique  from  before  to  behind,  and  above 
to  below,  and  joins  the  preceding  two.  The  anterior  border 
is  oblique  in  the  same  direction,  and  is  intimately  attached 
to  the  anterolateral  ligament  of  the  pedal  articulation. 
The  cartilages  of  the  fore-feet  are  thicker  and  more  exten- 
sive than  those  of  the  hind. 

2.  The  Plantar  Cushion  or  Fibro-fatty  Frog. — Com- 
posed of  a  fibrous  meshwork,  in  the  interstices  of  which  are 
lodged  fine  elastic  and  connective  fibres  and  fat  cells,  this 
wedge-shaped  body  occupies  the  space  between  the  two 
lateral  cartilages,  the  extremity  of  the  perforans  tendon, 
and  the  horny  frog.  It  offers  for  consideration  an  antero- 
superior  and  an  infero-posterior  face,  a  base,  an  apex,  and 
two  borders. 

The  antero-superior  face  is  in  contact  with  the  terminal 
expansion  of  the  perforans  tendon.  The  infero-posterior 
face  is  covered  by  the  keratogenous  membrane,  and  follows 
closely  the  shape  of  the  horny  frog,  on  whose  inner  surface 
it  is  moulded.  It  presents,  therefore,  at  its  centre  a  single 
conical  prolongation,  the  Pyramidal  Body,  which  is  con- 
tinued behind,  as  is  the  horny  frog,  in  the  shape  of  two 
lateral  ridges  divided  by  a  median  cleft.  The  base  of  the 
cushion  lies  behind,  and  consists  of  two  lateral  masses, 
the  Bulbs  of  the  Plantar  Cushion.  In  front  these  are 
continuous  with  the  ridges  of  the  pyramidal  body,  while 
behind  they  become  confounded  with  the  lateral  cartilages 
and  the  coronary  cushion.  The  apex  is  fixed  into  the 
plantar  surface  of  the  os  pedis,  in  front  of  its  semilunar 
ridge.  The  borders,  right  and  left,  are  wider  behind  than 
before,  and  are  in  relation  with  the  inner  faces  of  the  lateral 
cartilages. 

H.    THE   KERATOGENOUS    MEMBRANE. 

The  Keratogenous,  or  Horn-producing  Membrane,  is 
in  reality  an  extension  of  the  dermis  of  the  digit.  It 
covers  the  extremity  of  the  digit  as  a  sock  covers  the  foot, 


REGIONAL  ANATOMY  33 

spreading  over  the  insertion  of  the  extensor  pedis,  the 
lower  half  of  the  external  face  of  the  lateral  cartilages, 
the  bulbs  of  the  plantar  cushion,  the  pyramidal  body,  the 
anterior  portion  of  the  plantar  surface  of  the  os  pedis,  and 
over  the  anterior  face  of  the  same  bone.  In  turn,  as  the 
human  foot  with  its  sock  is  covered  by  the  boot,  this  is 
encased  by  the  hoof,  the  formation  of  which  we  shall  study 
later. 

To  expose  the  membrane  for  study  the  hoof  must  be 
removed.  This  may  be  done  in  two  ways.  By  roasting  in 
a  fire,  and  afterwards  dragging  off  the  horny  structures 
with  a  pair  of  pincers,  a  knife  having  first  been  passed 
round  the  superior  edge  of  the  horny  box.  Or  by  macera- 
tion in  water  for  several  days,  when  the  hoof  will  become 
loosened  by  the  process  of  decomposition,  and  may  be  easily 
removed  by  the  hands.  The  latter  method  is  less  likely 
to  injure  the  sensitive  structures,  and  will  expose  them 
with  a  fresh  appearance  for  observation. 

For  purposes  of  description  the  keratogenous  membrane 
is  divided  into  three  regions : 

1.  The  Coronary   Cushion. 

2.  The  Velvety  Tissue. 

3.  The  Podophyllous  Tissue,  or  the  Sensitive  Laminae. 

1.  The  Coronary  Cushion. — In  the  foot  stripped  of  the 
hoof  the  coronary  cushion  is  seen  as  a  rounded  structure 
overhanging  the  sensitive  laminae  after  the  manner  of  a 
cornice.  It  extends  from  the  inner  to  the  outer  bulbs  of 
tfie  plantar  cushion,  and  is  bounded  above  by  the  perioplic 
ring,  and  below  by  the  laminae. 

When  in  situ  it  is  accommodated  by  the  Cutigeral  Groove, 
a  cavity  produced  by  the  bevelling  out  of  the  superior  por- 
tion of  the  inner  face  of  the  wall  of  the  hoof.  Its 
superior  surface  is  covered  by  numerous  elongated  papillae, 
set  so  closely  as  to  give  the  appearance  of  the  'pile'  of 
velvet.  This  is  observed  to  the  best  advantage  wTith  the 
foot  immersed  in  water. 

The  Superior  Border  of  the  cushion  is  bounded  by  the 


34 


DISEASES  OF  THE  HORSE'S  FOOT 


Perioplic  Ring,  the  cells  of  which  have  as  their  function 
the  secreting  of  the  Periople,  a  layer  of  thin  horn  to  be 
noted  afterwards  as  covering-  the  external  face  of  the  wall. 
From  the  perioplic  ring  the  cushion  is  separated  by  a 
narrow  and  shallow,  though  well-marked,  groove. 

The  inferior  border  is  bounded  by  the  sensitive  laminae. 


Fig.  17. — The  Keratogenous  Membrane  (Viewed  from  the  Side). 
(The  Hoof  removed  by  Maceration) 

i .  The  sensitive  laminae,  or  podophyllous  tissue ;  2,  the  coronary  cushion ; 
3,  the  perioplic  ring;  4,  portion  of  plantar  cushion;  5.  groove 
separating  perioplic  ring  from  coronary  cushion ;  6.  the  sensi- 
tive sole. 

The  upper  portions  of  the  laminae,  those  in  contact  with 
the  cushion,  are  pale  in  contrast  with  the  portions  imme- 
diately below,  and  thus  there  is  given  the  appearance  of  a 
white  zone  adjoining  the  inferior  border  of  the  cushion. 

Widest  at  its  centre,  the  cushion  narrows  towards  its 
extremities,  which,  arriving  at  the  bulbs  of  the  plantar 
cushion,   bend   downwards   into   the   lateral    lacunae   of   the 


REGIONAL  ANATOMY 


35 


pyramidal  body,  where  they  merge  into  the  velvety  tissue 
of  the  sole  and  frog. 

The   papillae   of   the   coronary   cushion   secrete   the  horn 
tubules  forming  the  wall,  and  the  papillae  of  the  perioplic 


Fig.   18. — The   Keratogenous   Membrane   (Viewed  from  Below). 
(The   Hoof  removed  by  Maceration.) 

i,  The  sensitive  sole;  2,  the  sensitive  frog* — (a)  its  median  lacuna, 
(b)  its  lateral  lacuna;  3,  V-shaped  depression  accommodating 
the  toe-stay;  4,  the  sensitive  laminae  which  interleave  with  the 
horny  laminae  of  the  bar. 

*  The  sensitive   frog   thinly  invests  the  plantar  cushion  or  fibro- 
fatty   frog,  the  outline  of  which  is  here  indicated. 

ring  secrete  the  varnish-like  veneer  of  thin  horn  covering 
the  outside  surface  of  the  hoof. 

2.    Tin-:   Vei a'kty   Tissue. — This   is   the   portion   of   the 
keratogenous  membrane  covering  the  plantar  surface  of  the 


36  DISEASES  OF  THE  HORSE'S  FOOT 

os  pedis  and  the  plantar  cushion.  To  the  irregularities  of 
the  latter  body — its  bulbs,  pyramidal  body,  and  its  lacunae 
— It  is  closely  adapted.  Its  surface  may,  therefore,  be 
divided  into  (a)  The  Sensitive  Frog,  and  (b)  The  Sensitive 
Sole. 

(a)The  Sensitive  Frog  is  that  part  of  the  velvety  tissue 
moulded  on  the  lower  surface  of  the  plantar  cushion.  The 
shape  of  the  plantar  cushion  has  already  been  described  as 
identical  with  that  of  the  horny  frog.  It  only  remains  to 
state  that,  like  the  coronary  cushion,  the  surface  of  the 
sensitive  frog  is  closely  studded  with  papillae.  The  cells 
clothing  the  papillae  are  instrumental  in  forming  the  horny 
frog. 

(b)  The  Sensitive  Sole. — As  its  name  indicates,  this  is 
the  portion  of  the  keratogenous  membrane  that  covers  the 
plantar  surface  of  the  os  pedis.  It  also  is  clothed  with 
papillae,  which  again  give  rise  to  the  formation  of  that  part 
of  the  horny  box  to  which  they  are  adapted — namely,  the 
sole. 

3.  The  Podophyllous  Tissue,  or  Sensitive  Laminje. — 
This  portion  of  the  keratogenous  membrane  is  spread  over 
the  anterior  face  and  sides  of  the  os  pedis,  limited  above  by 
the  coronary  cushion,  and  below  by  the  inferior  edge  of 
the  bone.  It  presents  the  appearance  of  fine  longitudinal 
streaks,  which,  when  closely  examined  with  a  needle,  are 
found  to  consist  of  numerous  fine  leaves.  These  extend 
downwards  from  the  lower  border  of  the  coronary  cushion 
to  the  inferior  margin  of  the  os  pedis.  At  this  point  each 
terminates  in  several  large  villous  prolongations,  which 
extend  into  the  horny  tubes  at  the  circumference  of  the 
sole.  At  the  point  of  the  toe  this  membrane  sometime, 
shows  a  V~shaPed  depression,  into  which  fits  a  y^-shaped 
prominence  on  the  inner  surface  of  the  wall  at  this  point. 

The  sensitive  laminae  increase  in  width  from  above  to 
below.  Their  free  margin  is  finely  denticulated,  while 
their  sides  are  traversed  from  top  to  bottom  by  several 
folds  (about  sixty),  which,  examined  microscopically,  are 
seen  to  consist  of  secondary  leaves,  or  laminellce. 


REGIONAL  ANATOMY  37 

Examined  on  the  foot,  deprived  of  its  horny  covering, 
the  sensitive  laminae  are,  the  majority  of  them,  in  close 
contact  with  each  other.  In  the  normal  state  this  is  not 
so.  The  interstices  between  the  leaves  are  then  occupied 
by  the  horny  leaves,  to  be  afterwards  described  as  existing 
on  the  inner  surface  of  the  wall. 

Reaching  and  rounding  the  heels,  the  sensitive  laminae 
extend  forward  for  a  short  distance,  where  they  interleave 
with  the  horny  laminae  of  the  bars. 

Much  discussion  has  centred  round  the  point  as  to 
whether  or  no  the  cells  of  the  sensitive  laminae  take  any 
share  in  the  formation  of  the  horn  of  the  wall.  This  will 
be  alluded  to  in  a  future  chapter. 

I.    THE   HOOF. 

Removed  from  the  foot  by  maceration  a  well-shaped  hoof 
is  cylindro-conical  in  form,  and  appears  to  the  ordinary 
observer  to  consist  of  a  box  or  case  cast  in  one  single  piece 
of  horn.  Prolonged  maceration,  however,  will  show  that 
the  apparently  single  piece  is  divisible  into  three.  These 
are  known  as  (  1)  The  Wall,  (2)  The  Sole,  and  (3)  The 
Frog.  In  addition  to  these,  we  have  also  an  appendage 
or  circular  continuation  of  the  frog  named  (4)  The  Peri- 
ople,  or  Coronary  Frog  Band.  These  various  divisions 
we  will  study  separately. 

1.  The  Wall  is  that  portion  of  the  hoof  seen  in  front 
and  laterally  when  the  horse's  foot  is  on  the  ground. 
Posteriorly,  instead  of  being  continued  round  the  heels  to 
complete  the  circle,  its  extremities  become  suddenly 
inflected  downwards,  forwards,  and  inwards.  These  in- 
flections can  only  be  seen  with  the  foot  lifted  from  the 
floor,  and  form  the  so-called  Bars.  It  will  be  noticed,  too, 
with  the  foot  lifted,  that  the  wall  projects  beyond  the  level 
of  the  other  structures  of  the  plantar  surface,  taking  upon 
itself  the  bearing  of  the  greatest  part  of  the  animal's 
veight. 

The  horn  of  the  wall,  viewed  immediately  from  the  front, 


38 


DISEASES  OF  THE  HORSE'S  FOOT 


is  known  as  the  Toe,  which  again  is  distinguished  as 
Outside  Toe  or  Inside  Toe,  according  as  the  horn  to  it:, 
inner  or  outer  aspect  is  indicated.  The  remainder  of  the 
external  face  of  the  wall,  that  running  back  to  the  heels,  is 
designated  the  Quarters. 

In  the  middle  region  of  the  toe,  the  wall  following  the 
angle  of  the  bones  is  greatly  oblique.  This  obliquity 
decreases  as  the  quarters  are  reached,  until  on  reaching 
the  heels  the  wall  is  nearly  upright. 


Fig.  19.— The  Wall  of  the  Hoof. 

I,  The  toe;  2,  inner  toe;  3,  outside  toe;  4,_  the  quarter;  5,  eutigeral 
groove ;  6,  horny  lamina?. 

For  observation  the  wall  offers  two  faces,  two  borders, 
and  two  extremeties. 

The  External  Face  is  convex  from  side  to  side,  but 
straight  from  the  upper  to  the  lower  border.  Examined 
closely,  it  is  seen  to  be  made  up  of  closely-arranged 
parallel  fibres  running  in  a  straight  line  from  the  upper 
to  the  lower  border,  and  giving  the  surface  of  the  foot  a 
finely  striated  appearance.  In  addition  to  these  lines, 
which  are  really  the  horn  tubules,    the    external    face  is 


REGIONAL  ANATOMY 


39 


marked  by  a  series  of  rings  which  run  horizontally  from 
heel  to  heel.  These  are  due  to  varying  influences  of  food, 
climate,  and  slight  or  severe  disease.  This  will  be  noted 
again  in  a  later  page.  In  a  young  and  healty  horse  the 
whole  of  the  external  face  of  the  wall  is  smooth  and 
shining.  This  appearance  is  due  to  a  thin  layer  of  horn, 
secreted  independently  of  the  wall  proper,  termed  the  peri- 
ople. 

The  Internal  Face  of  the  wall,  that  adapted  to  the  sensi- 
tive laminae,  is  closelv  covered  over  its  entire  surface  with 


Fig.  20.— Internal  Features  of  the  Wall.  Frog,  and  Sole 
(Mesian  Section  of  Hoof), 

i,  Horny  laminae  covering  internal  face  of  wall;  2,  superior  border  of 
wall;  3,  junction  of  wall  with  horny  sole  ;  4,  the  cutigeral  groove  ; 
5,  the  horny  sole  ;  6,  the  horny  frog  ( that  portion  of  it  known  as 
the  'frogstay')  ;  7,  A-*haped  ridge  on  wall  and  sole  (known  as 
the  'toe-stay')  ;  8,  anterior  face  of  wall ;  9,  inferior  border  of  wall. 

white  parallel  leaves  (  Keraphyllor,  or  horn  leaves,  to  distin- 
guish them  from  the  Podopli\Ua\  or  sensitive  leaves ).  These 
keraphylke  dovetail  intimately  with  the  sensitive  laminae, 
covering  the  os  pedis.  Running  along  the  superior  portion 
of  the  inner  face  is  the  Cutigeral  Groove.  This  cavity  has 
been  mentioned  before  as  accommodating  the  coronary 
cushion,  whose  shape  and  general  contour  it  closely  follows, 
being  widest  and  deepest  in  front,  and  gradually  decreasing 
as  it  proceeds  backwards.  It  is  hollowed  out  at  the 
expense  of  the  wall,  and  shows  on  its  surface  numberless 


40  DISEASES  OF  THE  HORSE'S  FOOT 

minute  openings  which  receive  the  papillae  of  the  coronary 
cushion. 

At  the  bottom  of  the  internal  face,  at  the  point  where 
the  toe  joins  the  sole,  will  be  noted  the  before-mentioned 
y^ -shaped  prominence.  Its  position  will  be  clearly  under- 
stood when  we  say  that  it  gives  the  appearance  of  having 
been  forced  there  by  the  pressure  of  the  toe-clip  of  the 
shoe.     This  will  be  noted  again  when  dealing  with  the  sole. 

The  Inferior  Border  of  the  wall  offers  little  to  note.  It 
is  that  portion  in  contact  with  the  ground,  and  subject  to 
wear.  A  point  of  interest  is  its  union  with  the  sole. 
This  will  be  noticed  in  a  foot  which  has  just  been  pared 
as  a  narrow  white  or  faint  yellow  line  on  the  inner  or 
concave  face  of  the  wall  at  its  lower  portion.  It  marks 
the  point  where  the  horny  leaves  of  the  wall  terminate  and 
become  locked  with  corresponding  leaves  of  the  circum- 
ference of  the  sole. 

The  Superior  Border  follows  closely  the  line  marked  by 
the  periople  ring  and  the  groove  separating  the  latter  from 
the  coronary  cushion. 

The  Extremities  of  the  wall  are  formed  by  the  abruptly 
reflected  portions  of  the  wall  at  the  heels.  Termed  by  some 
the  'Inflexural  Nodes,'  they  are  better  known  to  us  as  the 
'Points  of  the  Heels.' 

2.  The  Sole. — The  sole  is  a  thick  plate  of  horn  which, 
in  conjunction  with  the  bars  and  the  frog,  forms  the  floor 
of  the  foot.  In  shape  it  is  irregularly  crescentic,  its  posterior 
portion,  that  between  the  horns  of  the  crescent,  being 
deeply  indented  in  a  V"snaPec^  manner  to  receive  the  frog. 
Its  upper  surface  is  convex,  its  lower  concave.  It  may  be 
recognized  as  possessing  two  faces  and  two  borders. 

The  Superior  or  Internal  Face  is  adapted  to  the  sole  of 
the  os  pedis.  Its  highest  point,  therefore,  is  at  the  point 
of  its  V'~snaped  indentation.  From  this  point  it  slopes  in 
every  direction  downwards  and  outwards  until  near  the 
circumference.  Here  it  curves  up  to  form  a  kind  of  a 
groove  in  which  is  lodged  the  inferior  edge  of  the  os  pedis. 
In  the  centre  of  its  anterior  portion — that  is  to  say,  at  the 


REGIONAL  ANATOMY  41 

toe — will  be  seen  a  small  /\ -shaped  ridge,  which  is  a  direct 
continuation  of  the  same  shaped  prominence  before  men- 
tioned on  the  internal  face  of  the  wall  This  Fleming  has 
termed  the  toe-stay,  from  a  notion  that  it  serves  to  maintain 
the  position  of  the  os  pedis.  The  whole  of  the  superior 
face  of  the  sole  is  covered  with  numerous  fine  punctures 
which  receive  the  papillae  of  the  sensitive  sole. 

The  Inferior  Face  is  more  or  less  concave  according  to 
circumstances,  its  deepest  part  being  at  the  point  of  the 
frog.      Sloping   from   this   point   to    its    circumference,   it 


Fig.  21. — Inferior  Aspect  of  Hoof. 

a.  The  inferior  face  of  horny  sole :  b  ;  inferior  border  of  the  wall ; 
c,  body  or  cushion  of  the  frog;  d.  median  lacuna  of  the  frog; 
e,  lateral  lacuna  of  the  frog;  /.  the  bar;  g,  the  quarter;  //,  the 
point  of  the  frog;  i,  the  heel. 

becomes   suddenly  fiat  just    before  joining  the  wall.      Its 
horn  in  appearance  is  flaky. 

The  External  Border  or  Circumference  is  intimately  dove- 
tailed with  the  horny  laminae  of  the  wall.  At  its  circum- 
ference the  sole,  if  unpared,  is  ordinarily  as  thick  as  the 
wall.  This  thickness  is  maintained  for  a  short  distance 
towards  its  centre,  after  which  it  becomes  gradually  more 
thin. 

The  Internal  Border  has  the  shape  of  an  elongated  V 
with  the  apex  pointing  forwards.     It  is  much  thinner  than 


42 


DISEASES  OF  THE  HORSE'S  FOOT 


the  external  border,  and,  like  it,  is  dovetailed  into  the 
horny  laminae  of  the  inflections  of  the  wall — namely,  the 
bars.  In  front  of  the  termination  of  the  bars  it  is  dove- 
tailed into  the  sides  and  point  of  the  frog.  Where  unworn 
by  contact  with  the  ground,  the  horn  of  the  sole  is  shed  by 
a  process  of  exfoliation. 

3.     The  Frog. — Triangular  or  pyramidal  in  shape,  the 
frog  bears  a  close  resemblance  to  the  form  of  the  plantar 


4- ...h|..: 


Fig.  22. — Hoof  with  the  Sensitive  Structures  removed. 

I,  Superior  face  of  horny  frog;  2,  the  frog-stay;  3,  the  lateral  ridges 
of  the  frog's  superior  surface ;  4,  the  horny  laminae  at  the  in- 
flections of  the  wall. 


cushion,  upon  the  lower  surface  of  which  body  it  is 
moulded.  It  offers  for  consideration  two  faces,  two  sides, 
a  base,  and  a  point  or  summit. 

The  Superior  Face  is  an  exact  cast  of  the  lower  surface 
of  the  plantar  cushion.  It  shows  in  the  centre,  therefore, 
a  triangular  depression,  with  the  base  of  the  triangle 
directed  backwards.  Posteriorly,  the  depression  is  con- 
tinued as  two  lateral  channels  divided  by  a  median  ridge. 


REGIONAL  ANATOMY  43 

"i  he  median  ridge  widens  out  as  it  passes  backwards, 
forming  the  larger  part  of  the  posterior  portion  of  the  frog. 
This  median  ridge  fits  into  the  cleft  of  the  plantar  cushion. 
It  serves  to  prevent  displacement  of  the  sensitive  from 
the  horny  frog,  and  has  been  rather  aptly  termed  the 
'Frog-stay.' 

The  Inferior  Surface  is  an  exact  reverse  of  the  superior. 
The  triangular  depression  of  the  superior  surface  is  repre- 
sented in  the  inferior  surface  by  a  triangular  projection, 
and  the  ridge-like  frog-stay  of  the  upper  surface  is 
represented  below  by  a  median  cleft,  the  Median  Lacuna 
of  the  frog.  The  triangular  projection  in  front  of  the 
median  lacuna  is  the  body  or  cushion  of  the  frog.  It  is 
continued  backwards  as  two  ridge-like  branches,  which,  at 
the  points  of  the  heels,  form  acute  angles  with  the  bars. 
On  the  outer  side  of  each  lateral  ridge  is  a  fissure.  These 
are  known  as  the  Lateral  Lacuna?. 

The  Sides  of  the  frog  are  flat  and  slightly  oblique.  They 
are  closely  united  to  the  bars  and  to  the  triangular  inden- 
tation in  the  posterior  border  of  the  sole. 

The  Base  of  the  frog  is  formed  by  the  extremities  of  its 
branches,  which,  becoming  wider  and  more  convex  as  they 
pass  backwards,  form  two  rounded,  flexible,  and  elastic 
masses  separated  from  each  other  by  the  medium  lacuna. 
These  constitute  the  'glomes'  of  the  frog.  They  are  con- 
tinuous with  the  periople. 

The  Point  of  the  Frog  is  situated,  wedge-like,  within  the 
triangular  notch  in  the  posterior  border  of  the  sole. 

4.  The  Periople,  or  Coronary  Frog  Band. — This  is  a 
continuation  of  the  substance  of  the  frog  around  the 
extreme  upper  surface  of  the  hoof.  It  is  widest  at  the 
heels  over  the  bulbs  or  glomes  of  the  frog,  and  gradually 
narrows  as  it  reaches  the  front  of  the  hoof.  It  is,  in  reality, 
a  thin  pellicle  of  semi-transparent  horn  secreted  by  the 
cells  of  the  perioplic  ring.  When  left  untouched  by  the 
farrier's  rasp  it  serves  the  purpose,  by  acting  as  a  natural 
varnish,  of  protecting  the  horn  of  the  wall  from  the  effects 
of  undue  heat  or  moisture. 


CHAPTER  III. 

GENERAL   PHYSIOLOGICAL  AND   ANATOMICAL 
OBSERVATIONS 

The  matter  embraced  by  the  heading  of  this  chapter  will 
offer  for  discussion  many  subjects  of  great  interest  to  the 
veterinary  surgeon.  Around  some  of  them  debate  has  for 
many  years  waxed  more  than  keen.  Of  the  points  in 
dispute,  some  of  them  may  be  regarded  as  satisfactorily 
settled,  while  others  offer  still  further  room  for  investi- 
gation. 

In  this  volume  we  can  only  hope  to  deal  with  them  in 
brief,  and  must  select  such  as  appear  to  have  the  greatest 
bearing  on  the  veterinarian's  everyday  practice. 

Always  prolific  of  heated  discussion  has  been  one  ques- 
tion:  'Are  the  horny  laminae  secreted  by  the  sensitive?'  To 
answer  this  satisfactorily,  it  will  be  best  to  give  a  short 
account  of  the  mode  of  production  of  the  hoof  in  general. 

A.    DEVELOPMENT  OF  THE  HOOF. 

Starting  with  the  statement  that  it  is  epidermal  in  origin, 
we  will  first  consider  the  structure  of  the  skin,  and  follow 
that  with  a  brief  description  of  the  structure  and  mode  of 
growth  of  the  human  nail,  a  short  study  of  which  will 
greatly  assist  us  when  we  come  to  investigate  the  manner 
of  growth  of  the  horse's  hoof. 

The  Skin  is  composed  of  two  portions,  the  Epidermis 
and  the  Corium. 

The  Epidermis  is  a   stratified  epithelium.     The  super- 

44 


GENERAL  OBSERVATIONS 


45 


ficial  layers  of  the  cells  composing  it  are  hard  and  horny, 
while  the  deeper  layers  are  soft  and  protoplasmic.  These 
latter  form  the  so-called  Rete  Mucosum  of  Malpighi. 

Commencing   from   below    and   proceeding   upwards,   we 
rind  that   the  lowermost  cells  of  the  rete  mucosum,  those 


B 


Fig.   23.— Vertical   Section   of   Epidermis    (Human).     (After 
Ranvier.) 

.  The  horny  layer  of  the  epidermis  ;  B.  the  rete  mucosum  ;  (7,  the 
columnar  pigment-containing  cells  of  the  rete;  b,  the  polyhedral 
cells ;  c,  the  stratum  granulosum ;  d.  the  stratum  lucidum  ;  e, 
swollen  horny  cells;  /,  the  stratum  squamosum. 


that  are  set  immediately  on  the  corium,  are  columnar  in 
shape.  In  animals  that  have  a  coloured  skin  these  cells 
contain  pigment  granules.  Directly  superposed  to  these 
we  find  cells  which  in  shape  are  polyhedral.  Above  them, 
and  forming  the  most  superficial  layer  of  the  rete  mucosum, 


46  DISEASES  OF  THE  HORSE'S  rOOT 

is  a  series  of  flattened,  granular-looking  cells  known  as  the 
stratum  granulosum. 

Immediately  above  the  stratum  granulosum  the  horny 
portion  of  the  epidermis  commences.  In  the  human  skin 
this  is  formed  of  three  distinct  layers.  Undermost  a  layer 
of  clear  compressed  cells,  the  stratum  lucidum.  Next  above 
it  a  layer  of  swollen  cells,  the  nuclei  of  which  are  indis- 
tinguishable. Finally,  a  surface  layer  of  thin,  horny  scales, 
the  stratum  squamosum,  which  become  detached  and  thrown 
off  in  the  form  of  scurf  or  dandruff.  In  the  skin  of  the 
horse,  except  where  it  is  thickest,  these  layers  are  not 
clearly  defined. 

It  is  the  Malpighian  layer  of  the  epidermis  that  is  most 
active  in  cell  division.  As  they  are  formed  the  new  cells 
push  upwards  those  already  there,  and  the  latter  in  their 
progress  to  the  surface  undergo  a  chemical  change  in  which 
their  protoplasm  is  converted  into  horny  material.  This 
change,  as  we  have  already  indicated,  takes  place  above 
the  stratum  granulosum. 

In  addition  to  its  constant  formation  of  cells  to  replace 
those  cast  off  from  the  surface,  the  active  proliferation  of 
the  elements  of  the  Malpighian  layer  is  responsible  for  the 
development  of  the  various  appendages  of  the  skin,  the 
hairs  with  their  sebaceous  glands,  the  sweat  glands,  horny 
growths  and  the  hoof,  and,  in  the  human  subject,  the 
nail.  These  occur  as  thickenings  and  down-growths  of  the 
epithelium  into  the  corium. 

The  epidermis  is  devoid  of  bloodvessels,  but  is  provided 
with  fine  nerve  fibrils  which  ramify  between  the  cells  of 
the  rete  mucosum. 

The  Corium  is  composed  of  dense  connective  tissue,  the 
superficial  layer  of  which  bears  minute  papillae.  These 
project  into  the  epidermis,  which  is  moulded  on  them. 
For  the  most  part  the  papillae  contain  looped  capillary 
vessels,  rendering  the  superficial  layer  of  the  corium 
extremely  vascular.  Why  this  must  be  a  moment's  reflec- 
tion will  show.  The  epidermis,  as  we  have  already  said* 
is  devoid  of  bloodvessels.      It  therefore    depends  entirely 


GENERAL  OBSERVATIONS  47 

for  its  nourishment  upon  the  indirect  supply  it  receives 
from  the  vessels  of  the  corium.  The  need  for  extreme 
vascularity  of  the  corium  is  further  explained  when  we  call 
to  mind  the  constant  proliferation  and  casting  oft*  of  the 
cells  of  the  epidermis,  the  growth  of  the  hairs,  the  pro- 
duction of  the  horn  of  the  hoof,  and  the  work  performed 
by  the  numerous  sweat  and  other  glands. 

Others  of  the  papillae  contain  nerves,  ending  here  in 
tactile  corpuscles,  or  continuing,  as  we  have  mentioned 
before,  to  ramify  as  line  fibrils  in  the  rete  mucosum  of  the 
epidermis. 

The  Hairs  are  growths  of  the  epidermis  extending 
downwards  into  the  deeper  part  of  the  corium.  Each  is 
developed  in  a  small  pit,  the  Hair  Follicle,  from  the  bottom 
of  which  it  grows,  the  part  lying  within  the  follicle  being 
known  as  the  Root.  It  is  important  to  note  their  structure, 
as  it  will  be  seen  later  that  they  bear  an  extremely  close 
relation  to  the  horn  of  the  hoof. 

Under  a  high  power  of  the  microscope,  and  in  optical 
section,  the  central  portion  of  a  hair  is  tube-like.  In  some 
cases  the  cavity  of  the  tube  is  occupied  by  a  dark  looking 
substance  formed  of  angular  cells,  and  known  as  the 
Medulla.  The  walls  of  the  tube,  or  the  main  substance  of 
the  hair,  is  made  up  of  a  pigmented,  horny,  fibrous  material. 
This  fibrous  structure  is  covered  by  a  delicate  layer  of 
finely  imbricated  scales,  and  is  termed  the  Hair  Cuticle. 

The  root  of  the  hair,  that  portion  within  the  follicle,  has 
exactly  the  same  formation  save  at  its  extreme  end.  Here 
it  becomes  enlarged  into  a  knob-like  formation  composed 
of  soft,  growing  cells,  which  knob-like  formation  fits  over 
a  vascular  papilla  projecting  up  in  the  bottom  of  the 
follicle. 

We  have  already  stated  that  the  hairs  are  down-growths 
of  the  epidermis.  It  follows,  therefore,  that  the  hair 
follicles,  really  depressions  or  cul-de-sacs  of  the  skin  itself, 
are  lined  by  epithelial  cells  and  connective  tissue.  So 
closely  does  the  epidermal  portion  of  the  follicle  invest  the 
hair  root  that  it  is  often  dragged  out  with  it,  and  is  known 


48 


DISEASES  OF  THE  HORSE'S  FOOT 


as  the  Root  Sheath.  This  is  made  up  of  an  outer  layer  of 
columnar  cells  {the  outer  root  sheath)  corresponding  to  the 
Malpighian  layer  of  the  epidermis,  and  of  an  inner  horny 
layer,  next  to  the  hair,  corresponding  to  the  more  super- 
ficial layer  of  the  epidermis,  and  known  as  the  inner  root 
sheath. 

The  hair  grows   from  the    bottom    of    the  follicle  by  a 
multiplication  of  the  cells  covering  the  papilla  upon  which 


Fig.  24. — Section  of  Skin  with  Hair  Follicle  and  Hair. 

The  hair  follicle;  b,  the  hair  root;  c,  the  medulla;  d,  the  hair 
cuticle;  e,  the  outer  root  sheath;  /,  the  inner  root  sheath;  g,  the 
papilla  from  which  the  hair  is  growing;  h,  a  sebaceous  gland; 
i,  a  sudoriferous  gland. 


its  root  is  moulded.  When  a  hair  is  cast  off  a  new  one  is 
produced  from  the  cells  covering  papilla,  or,  in  case  of 
the  death  or  degeneration  of  the  original  papilla,  the  new 
hair  is  produced  from  a  second  papilla  formed  in  place  of 
the  first  at  the  bottom  of  the  follicle. 

The  Sebaceous  Glands  are  small  saccular  glands  with 
their  ducts  opening  into  the  mouths  of  the  hair  follicles. 
They  furnish  a  natural  lubricant  to  the  hairs  and  the 
skin. 


GENERAL  OBSERVATIONS  49 

The  Sudoriferous  or  Sweat  Glands  are  composed  of 
coiled  tubes  which  lie  in  the  deeper  portion  of  the  skin, 
and  send  up  a  corkscrew-like  duct  or  open  on  the  surface 
of  the  epidermis.  They  are  numerous  over  the  whole  of 
the  body. 

The  Human  Nails  are  thickenings  of  the  lowermost 
layer  of  the  horny  portion  of  the  epidermis,  the  stratum 
lucidum.  They  are  developed  over  a  modified  portion  of 
the  corium  known  as  the  nail-bed.  The  horny  substance  of 
the  nail   is   composed  of  clear  horny   cells,  and   rests   im- 


Fig.   25. — Longitudinal   Section   through   Nail   and   Nail-bed 
of  a  Human  Foetal  Finger.* 

a,  The  nail;  b,  the  rete  mucosum ;  c,  the  longitudinal  ridges  of 
the  corium. 

mediately  upon  a  Malpighian  layer  similar  to  that  found  in 
the  epidermis  generally.  Instead  of  the  papilla?  present  else- 
where in  the  skin,  the  corium  of  the  nail-bed  is  marked 
by  longitudinal  ridges,  a  similar,  though  less  distinct, 
arrangement  to  that  found  in  the  laminae  of  the  horse's 
foot. 

*  Seeing  that  the  section  is  a  longitudinal  one,  it  would  appear  from 
the  way  the  ridges  cut  that  they  are  running  transversely  beneath 
the  nail.  Their  extreme  delicacy,  however,  prevents  a  single  one 
showing  itself  along  the  length  of  the  section,  and  their  constant 
accidental  cutting  makes  them  appear  to  run  transversely  ( H.  C.  R.). 


50  DISEASES  OF  THE  HORSE'S  FOOT 

Having  thus  paved  the  way,  we  are  now  in  a  better 
position  to  discuss  our  original  question  (Are  the  horny 
laminae  secreted  by  the  sensitive?),  and  better  able  to 
appreciate  the  work  that  has  been  done  towards  the  eluci- 
dation of  the  problem. 

A  most  valuable  contribution  to  this  study  is  an  article 
published  in  1896  by  Profesor  Mettam.*  Here  the  question 
is  dealt  with  in  a  manner  that  must  effectually  silence  all 
other  views  save  such  as  are  based  upon  similar  methods 
of  investigation  —  namely,  histological  examination  of 
sections  of  equine  hoofs  in  various  stages  of  foetal  develop- 
ment. 

Professor  Mettam  commences  by  drawing  attention  to 
the  error  that  has  been  made  in  this  connection  by  studying 
the  soft  structures  of  the  foot  separated  by  ordinary  putre- 
factive changes  from  the  horny  covering.  Tn  this  way/ 
the  writer  points  out,  'a  wholly  erroneous  idea  has  crept 
in  as  to  the  relation  of  the  one  to  the  other,  and  the  two 
parts  have  been  treated  as  two  anatomical  items,  when, 
indeed,  they  are  portions  of  one  and  the  same  thing.  As  an 
illustration,  and  one  very  much  to  the  point  at  issue,  the 
soft  structures  of  the  foot  are  to  the  horny  covering  what 
the  corium  of  the  skin  and  the  rete  Malpighii  are  to  the 
superficial  portions  of  the  epidermis.  Indeed,  the  point 
where  solution  of  continuity  occurs  in  macerating  is  along 
the  line  of  the  soft  protoplasmic  cells  of  the  rete.' 

In  the  foregoing  description  of  the  skin  we  have  seen 
that  the  corium  is  not  a  plane  surface,  but  that  it  is  studded 
by  numerous  papillary  projections,  and  that  these  pro- 
jections, with  the  depressions  between  them,  are  covered 
by  the  cells  of  the  epidermis. 

The  corium  of  the  horse's  foot,  however,  although 
possessed  of  papillae  in  certain  positions  (as,  for  example, 
the  papillae  of  the  coronary  cushion,  and  those  of  the 
sensitive  frog  and  sole),  has  also  most  pronounced  ridges 
(laminae)  which  run  down  the  whole  depth  of  the  os  pedis. 
Each  lamina  again  carries  ridges  (laminellae)  on  its  lateral 

*  The  Veterinarian,  vol.  lxix.,  p.  i. 


GENERAL  OBSERVATIONS  51 

aspects,  giving  a  section  of  a  lamina  the  appearance  of 
being  studded  with  papillae.  We  have  already  pointed  out 
the  ridge-like  formation  of  the  human  nail-bed,  and  noted 
that,  with  the  exception  that  the  secondary  ridges  are  not 
so  pronounced,  it  is  an  exact  prototype  of  the  laminal 
formation  of  the  corium  of  the  horse's  foot. 

The  distribution  of  the  laminae  over  the  foot  we  have 
discussed  in  the  chapter  devoted  to  the  grosser  anatomy. 
In  a  macerated  foot  the  sensitive  laminae  of  the  corium 
interdigitate  with  the  horny  laminae  of  the  hoof  ;  that  is 
to  say,  there  is  no  union  between  the  two,  for  the  simple 
reason  that  it  has  been  destroyed;  they  simply  interlock 
like  the  unglued  junction  of  a  finely  dovetailed  piece  of 
joinery.  But  no  further,  however,  than  the  irregularities 
of  the  underneath  surface  of  the  epidermis  of  the  skin  can 
be  said  to  interlock  with  the  papillae  of  the  corium  does 
interlocking  of  the  horny  and  sensitive  laminae  occur.  It 
is  only  apparent.  The  horny  laminae  are  simply  beauti- 
fully regular  epidermal  ingrowths  cutting  up  the  corium 
into  minute  leaf -like  projections. 

In  a  macerated  specimen,  then,  the  exposed  sensitive 
structures  of  the  foot  exhibit  the  corium  as  (  1  )  the  Coro- 
nary Cushion,  fitting  into  the  cutigeral  groove;  (2)  the 
Sensitive  Lamina,  clothing  the  outer  surface  of  the  ter- 
minal phalanx,  and  extending  to  the  bars;  (3)  the  Plantar 
Cushion,  or  sensitive  frog;  and  (4)  the  Sensitive  Sole. 

The  main  portion  of  the  wall  is  developed  from  the 
numerous  papillae  covering  the  corium  of  the  coronary 
cushion.  We  have  in  this  way  numberless  down-growing 
tubes  of  horn.  Professor  Mettam  describes  their  formation 
in  a  singularly  happy  fashion :  'Let  the  human  fingers 
represent  the  coronary  papillae,  the  tips  of  the  fingers  the 
summits  of  the  papillae,  and  the  folds  of  skin  passing  from 
linger  to  finger  in  the  metacarpophalangeal  region  the 
depressions  between  the  papillae.  Imagine  that  all  have  a 
continuous  covering  of  a  proliferating  epithelium.  Then 
we  shall  have  a  more  or  less  continuous  column  of  cells 
growing  from  the  tip  of  the  finger  or  papilla  (a  hollow  tube 


52  DISEASES  OF  THE  HORSE'S  FOOT 

of  cells  gradually  moving  from  off  the  surface  of  the  ringer 
or  papilla  like  a  cast),  and  similar  casts  are  passing  from  off 
all  the  fingers  or  papillae.'  i 

From  this  description  it  will  be  noticed  that  each  down- 
growing  tube  of  horn  bears  a  striking  resemblance  to  the 
growth  of  a  hair,  described  on  p.  47.  In  fact,  the  horn  tube 
may  be  regarded  as  what  it  really  is,  a  modified  hair. 

We  next  continue  Professor  Mettam's  illustration,  and 
note  how  the  modified  hairs  or  horn  tubes  become  as  it 
were  matted  together  to  form  the  hoof  wall.  The  cells 
lining  the  depressions  are  also  proliferating,  and  their 
progeny  serve  to  cement  together  the  hollow  casts  of  the 
papilla?,  thus  giving  the  inter-tubular  substance.  We  have 
thus  produced  hollow  tubes,  united  together  by  cells,  all 
arising  from  the  rete  Malpighii  of  the  coronary  corium. 
Section  of  the  lower  part  of  the  horn  tubes,  shows  them  to 
contain  a  cellular  debris. 

Thus,  in  all,  in  the  horn  of  the  wall  we  find  a  tubular,  an 
intertubular,  and  intratubular  substance.  In  fact,  hairs 
matted  together  by  intertubular  material,  and  only  differing 
from  ordinary  hairs  in  their  development  in  that  they  arise, 
not  from  papillae  sunk  in  the  corium,  but  from  papillae 
projecting  from  its  surface. 

Although  this  disposes  of  the  wall  proper,  there  still 
confronts  us  the  question  of  the  development  of  the  horny 
laminae.  To  accurately  determine  this  point  it  is  abso- 
lutely essential  to  examine,  histologically,  the  feet  from 
embryos. 

In  the  foot  of  any  young  ungulate  in  the  early  stages  of 
iutra-uterine  life  horizontal  sections  will  show  a  covering 
of  epidermis  of  varying  thickness.*  This  may  be  only  two 
or  three  cells  thick,  or  may  consist  of  several  layers. 
Lowermost  we  find  the  cells  of  the  rete  Malpighii.  As 
some  criterion  of  the  activity  with  which  these  are  acting,  it 
may  be  noted  that  with  the  ordinary  stains  their  nuclei 
take  the  dye  intensely.  The  cells  of  this  layer  rest  upon  a 
basement    membrane    separating    the    epidermis    from    the 

*  Equine  foetus,  seventy-seven  days  old. 


GENERAL    OBSERVATIONS  53 

corium.     At   this   stage   the   corium   has  a  perfectly  plane 
surface. 

The   next   stage   will   demonstrate   the   first   step   in   the 


Fig.  26. — Section  of  Foot  of  Equine  Foetus,  Seventy-seven 

Days  Old.  

The  rete  Malpighii  rests  on  a  plane  corium ;  the  rent  in  the  section  is 
along  the  line  of  the  cells  of  the  rete  (Mettam). 

formation  of  the  sensitive  laminae.*     The  plain  surface  of 
the  corium  has  now  become  broken  up,  and  what  is  noticed 


M 


*-- 


Fig.  27. — Section  from  Foot  of  Sheep  Embryo. 
It  shows  a  pronounced  epithelial  ingrowth  into  the  corium  (Mettam). 

is  that  the  broken-up  appearance  is  due  to  the  epithelial 
cells  irrupting  and  advancing  en  echelon  into  its  connective 

*  Sheep  embryo,  exact  age  unknown. 


54         DISEASES    OF    THE    HORSE'S    FOOT 

tissue.  Each  point  of  the  ingrowing  lines  of  the  echelon 
has  usually  one  cell  further  advanced  into  the  corium  than 
its  neighbors,  and  may  be  termed  the  apieal  cell.  The 
fine  basement  membrane  separating  epithelium  from  corium 
is  still  clearly  evident.  This  epidermal  irruption  of  the 
corium  takes  place  at  definite  points  right  round  the  foot. 
It  is  extremely  probable,  however,  that  it  commences  first 
at  the  toe  and  spreads  laterally. 

As  yet,  these  cellular  ingrowths  (which  are  destined  to  be 


3* 


Fig.  28. — Section  from   Calf  Embryo. 

The  epithelial   ingrowths   hang   down    from   the   epidermis  into   the 
corium  like  the  teeth  of  a  comb  (Mettam). 

the  horny  laminae,  and  cut  up  the  corium  into  sensitive 
laminae)  are  free  from  irregularities  or  secondary  laminae. 
Before  these  are  to  be  observed  other  changes  in  connection 
with  the  ingrowths  are  to  be  noticed. 

The  first  is  merely  that  of  elongation  of  the  epithelial 
processes  into  the  connective  tissue,  until  the  rete  Malpighii 
gives  one  the  impression  that  it  has  hanging  to  its  under- 
neath surface  and  into  the  corium  a  number  of  thorn-like 
processes.  These  extend  all  round  the  front  of  the  foot, 
and  even  in  great  part  behind.     Accompanying  this  elonga- 


GENERAL    OBSERVATIONS 


55 


tion  of  the  processes  is  a  condensation  of  the  epithelial 
cells  immediately  above  the  rete  Malpighii,  with  a  partial 
or  total  loss  of  their  nuclei.  This  is  the  first  appearance 
of  true  horn,  and  its  commencement  is  almost  coincident 
with  the  first  stages  of  ossification  of  the  os  pedis. 

With  the  appearance  of  horn  comes  difficulty  of  section- 
ing.   The  last  specimen  that  Professor  Mettam  was  able  to 


ifc 


m^mrm  * 


Fig.  29. — Section  of  an  Epithelial  Ingrowth  from  an  Equine 

Foetus. 

It  shows  commencing  secondary  laminar  ridges.  In  the  centre  are 
epithelial  cells  which  are  undergoing  change  into  horny  elements 
to  form  the  horncore,  or  'horny  lamina?'  (Mettam). 


satisfactorily  cut  upon  the  microtome  was  from  a  fcetus  be- 
tween three  and  four  months  old.  In  this  the  secondary 
laminar  ridges  were  clearly  indicated,  and  the  active  layer  of 
the  rete  Malpighii  could  be  traced  without  a  break  from  one 
ingrowing  epithelial  process  to  the  next,  and  around  this, 
following  all  the  irregularities  of  its  outline,  and  covering 
the  branches  of  the  nascent  laminae.  The  laminae  mostly 
show  this  branching  as  if  a  number  of  different  growing 


56  DISEASES  OF  THE  HORSE'S  FOOT 

points  had  arisen,  each  to  take  on  a  function  similar  to  the 
epithelial  process  as  it  at  first  appeared. 

In  the  centre  of  the  processes  a  few  nuclei  may  be 
observed,  but  they  are  scarce,  and  stain  only  faintly;  they 
have  arisen  from  the  cells  of  the  rete  Malpighii  which  have 
grown  into  the  corium.  In  fact,  the  active  cells  are  passing 
their  daughters  into  the  middle  of  the  process,  and  these 
pass  through  similar  stages  as  those  derived  from  the 
ensheathing  epidermis.  In  other  words,  the  daughter  cells 
of  the  constituents  of  the  rete  Malpighii  which  have  grown 
into  the  corium  pass  through  a  degeneration  precisely 
similar  to  that  undergone  by  cells  shed  at  desquamation, 
or  those  which  eventually  give  rise  by  their  agglutination 
to  a  hair. 

This  is  the  real  origin  of  the  horny  laminae,  and  the 
thickness  of  these  is  increased  merely  by  an  increase  in  the 
area  covered  by  the  cells  of  the  rete  Malpighii — i.  e.,  by  the 
development  of  secondary  laminar  ridges.  If  a  section 
from  a  foal  at  term  be  examined,  the  processes  will  be 
found  far  advanced  into  the  corium,  and,  occupying  the 
axis  of  each  process,  will  be  seen  a  horny  plate,  continuous 
with  the  horn  of  the  wall.  No  line  of  demarcation  can  be 
observed  between  the  horn  so  formed  and  the  intertubular 
material  of  the  wall.  They  merge  into  and  blend  with  each 
other,  with  no  indication  of  their  different  origins.  The 
cells  that  have  invaded  the  corium  have  thus  not  lost  their 
horn-forming  function.  There  has  merely  been  an  increase 
in  the  area  for  horn-producing  cells.  The  horny  processes 
are  continuous  writh  the  hoof  proper  at  the  point  where  the 
epithelial  ingrowth  first  commenced  to  invade  the  corium, 
and  fuses  here  with  the  horn  derived  from  the  cells  of  the 
rete  Malpighii  which  have  not  grown  inwards,  and  which 
are  found  between  the  processes  in  the  intact  foot.  From 
this  it  is  clear  that  some  considerable  portion  of  the  horn  of 
the  wall  is  derived  from  the  cells  of  the  rete  Malpighii 
covering  the  corium  of  the  foot.  It  becomes  even  more 
clear  when  we  remember  the  prompt  appearance  of  horn  in 
cases  where  a  portion,  or  the  whole,  of  the  wall  has  been 


GENERAL    OBSERVATIONS  57 

removed  by  operation  or  by  accident  (see  reported  cases  in 
Chapter  VII.). 

The  activity  of  the*  cells  of  the  rete  Malpighii  of  the 
corium  covering  the  remainder  of  the  foot  will  be  quite 
as  necessary  as  the  activity  of  the  cells  of  the  coronary 
papilla?  which  form  the  horn  tubes  themselves.  '  For,' 
in  Professor  Mettam's  own  words,  k  I  am  inclined  to  believe 
that  much  of  the  "  white  line  "  which  is  found  uniting  the 


Fig.  30.— Section  through  Hoof  and  Soft  Tissues  of  a  Foal  at 

Term. 

The  horn  of  the  wall  is  shown,  and  the  horn-core  ('horny  laminae') 
of  the  epithelial  ingrowth.  The  latter  has  advanced  far  into  the 
corium,  and  is  now  provided  with  abundant  secondary  laminar 
ridges  (Mettam). 

wall  of  the  hoof  to  the  sole  has  been  derived  from  the  horn 
formed  from  the  rete  of  the  foot  corium.  This  origin  will 
explain  the  absence  of  pigment  from  this  thin  uniting 
"  line,"  as  it  does  from  the  horn  lining  the  interior  of 
the  wall.  The  cells  of  the  rete  are  free  of  colouring 
matter.' 

From  the  matter  here  given  us  it  is  easy  to  understand 
how,  in  a  macerated  foot,  the  appearance  is  given  of  inter- 


58  DISEASES  OF  THE  HORSE'S  FOOT 

locking  of  the  sensitive  and  horny  laminae.  We  see  that 
the  horny  laminae  are  ingrowths  of  the  rete  Malpighii, 
ploughing  into  and  excavating  the  corium  into  the  shape  of 
leaves — the  sensitive  laminae.  Putrefactive  changes  simply 
break  into  two  separate  portions  what  originally  was  one 
whole,  by  destroying  the  cells  along  its  weakest  part.  This 
part  is  the  line  of  soft  protoplasmic  cells  of  the  rete 
Malpighii.  Thus  the  more  resistant  parts  (the  horn  on  the 
one  hand,  and  the  corium  covering  the  foot  on  the  other) 
are  easily  torn  asunder. 

As  a  result  of  the  evidence  we  have  quoted,  we  are  able 
to  answer  our  original  question  in  the  affirmative.  Seeing 
that  the  horny  and  the  sensitive  laminae  are  both  portions 
of  the  same  thing — namely,  a  modified  skin,  in  which  the 
epidermis  is  represented  by  the  horny  laminae,  and  the 
corium  by  the  sensitive — it  is  clear  to  see  that  the  cells 
covering  the  inspreading  horny  laminae  are  dependent  for 
their  growth  and  reproduction  upon  the  cells  with  which 
they  are  in  immediate  contact — namely,  those  of  the  sensi- 
tive laminae. — and  that  therefore  the  sensitive  laminae  are 
responsible  for  the  growth  of  the  horny. 


B.     CHEMICAL   PROPERTIES  AND   HISTOLOGY   OE   HORN. 

Horn  is  a  solid,  tenacious,  fibrous  material,  and  its 
density  in  the  hoof  varies  in  different  situations.  It  is 
softened  by  alkalies,  such  as  caustic  potash  or  soda  and 
ammonia,  the  parts  first  attacked  being  the  commissures, 
then  the  frog,  and  afterwards  the  sole  and  wall.  Strong 
acids,  such  as  sulphuric  acid  and  nitric  acid,  also  dis- 
solve it. 

The  chemical  composition  of  the  hoof  shows  it  to  be 
a  modification  of  albumin,  its  analysis  yielding  water,  a 
large  percentage  of  animal  matter,  and  materials  soluble 
and  insoluble  in  water.  The  proportions  of  these,  as  exist- 
ing in  the  various  parts  of  the  hoof,  have  been  given  by 
Professor  Clement  as  follows : 


GENERAL  OBSERVATIONS 


59 


Wall. 

Side. 

Frog. 

Water 

16:12 
9:95 
1:04 
0:26 

81:63 

36:0 
0:25 
1:50 
0:25 

62:0 

42:0 
0:50 
1:50 
0:22 

55:78 

Fatty  matter 

Matters  soluble  in  water..              ... 

Insoluble  salts 

Animal  matter 

Horn  appears  to  be  identical  with  epidermis,  hair,  wool, 
feathers,  and  whalebone,  in  yielding  '  keratin,'  a  substance 
intermediate  between  albumin  and  gelatine,  and  containing 
from  60  to  80  per  cent,  of  sulphur. 

That  horn  is  combustible  everyone  who  has  watched 
the   fitting  of  a  hot   shoe  knows.     That  it   is  a  bad  con- 


Fig.  31. — Perpendicular  Section  of  Horn  of  Wall. 


ductor  of  heat,  the  absence  of  bad  after-effects  on  the  foot 
testifies. 

In  a  previous  page  we  have  described  the  manner  of 
growth  of  the  horn  tubules,  and  noted  the  direction  they 
took  in  the  wall ;  also  we  have  noticed  the  existence  be- 
tween them  of  an  intertubular  horn  or  cement. 

Those  who  wish  to  give  this  subject  further  study  will 
find  an  excellent  series  of  articles  by  Fleming  in  the 
Veterinarian  for  1871.  We  shall  content  ourselves  here 
with  introducing  one  or  two  diagrams  and  photo-micro- 
graphs, and  dealing  with  the  histology  very  briefly. 

Under  the  microscope  the  longitudinal  striation  of  the 
wall  is  found  to  be  due  to  the  direction  taken  by  the  horn 
tubules. 


60  DISEASES  OF  THE  HORSE'S  FOOT 

Fig.  31  is  a  magnified  perpendicular  section  of  the  wall. 
In  it  the  parallel  dark  striae  are  the  horn  tubules  in  longi- 
tudinal section.  The  lighter  striae  represent  the  inter- 
tubular  material. 

Fig.  32  gives  us  the  wall  in  horizontal  section.  To  the 
left  of  this  picture  we  find  the  horn  tubules  cut  across,  and 
standing  out  as  so  many  concentrically  ringed  circles.  In 
the  centre  of  the  figure  are  seen  the  horny  laminae,  with 
their  laminellae,  and  the  sensitive  laminae.  The  right  portion 
of  the  figure  pictures  the  corium. 


V  • 

Fig.   32. — Horizontal   Section   of   Horn   of   Wall. 

Fig.  33  is,  again,  a  horizontal  section,  cut  this  time  at 
the  junction  of  the  wall  with  the  sole.  To  the  left  are  seen, 
again,  the  horn  tubules  of  the  wall,  and  to  the  centre  the 
horny  laminae.  In  this  position,  however,  the  structures 
interdigitating  with  the  horny  laminae  are  not  sensitive,  but 
are  themselves  horny.  As  the  diagram  shows,  they  con- 
tain regularly  arranged  horn  tubules  cut  across  obliquely. 
It  is  this  horn  which  forms  the  '  white  line.'  To  the 
extreme  right  of  the  figure  are  seen  the  horn  tubules  of  the 
sole. 

There  remains,  now  but  to  notice  the  arrangement  of  the 


GENERAL  OBSERVATIONS 


61 


c   a 

Fig,  33. — Horizontal  Section  of  Horn  through  the  Junction 
of  the  Wall  with  the  Sole. 

a,  Horn  tubule  of  the  wall ;  b,  horn  tubule  of  the  sole  ;  c.  d.  horny 

laminae. 


Fig.  34. — Section  of  Frog  through  Corium  and  Horn. 

The  long  finger-like  projections  of  corium  into  epidermis  are  sections 
of  the  long  papillae  from  which  the  horn-tubes  of  the  sole  grow. 
In  the  stainable  portion  of  the  epidermis  are  to  be  clearly  seen 
light  and  dark  streaks  pointing  out  the  alternate  strata-like  ar- 
rangement of  cells  mentioned  in  the  text  (Mettam). 


62  DISEASES  OF  THE  HORSE'S  FOOT 

horn  tubules  in  the  frog.  The  peculiar,  indiarubber-like 
toughness  of  this  organ  is  well  known.  Histological 
examination  gives  a  reason  for  this. 

The  horn  tubules  of  the  frog  are  sinuous  in  their  course. 
This  is  accounted  for  by  the  fact  that  in  the  horn  of  the 
frog  there  is  a  large  amount  of  intertubular  material,  this 
having  the  effect  of  frequently  turning  the  horn  tubules 
from  the  straight.  In  addition  to  this,  the  intertubular 
material  has  a  peculiar  arrangement  of  the  cells  composing 
it.  These  are  laid  down  in  alternating  striae  (1)  of  cells 
with  their  long  axes  longitudinal,  and  (2)  of  cells  with  their 
long  axes  horizontal.  This  is  seen  in  Fig.  34,  between  the 
long  papillae  of  the  corium,  where  the  lines  of  longitudinally 
arranged  cells  in  horizontal  section  stand  out  darker  than 
the  adjoining  strata  in  which  their  arrangement  is  hori- 
zontal. The  tortuous  direction  of  the  horn  tubules,  and 
the  almost  interlocking  nature  of  the  alternating  strata 
of  the  intertubular  material,  together  combine  to  give  the 
frog  its  characteristic  toughness  and  resiliency. 


C.    EXPANSION  AND  CONTEACTION  OF  THE  HOOF. 

Among  other  questions  productive  of  heated  argument 
come  those  relating  to  expansion  of  the  horse's  hoof.  In 
the  past  many  observers  have  strenuously  insisted  on  the 
fact  that  expansion  and  contraction  regularly  occur  during 
progression.  Opposed  to  them  have  been  others  equally 
firm  in  the  belief  that  neither  took  place.  Quite  within 
recent  times  this  question  also  has  been  settled  once  and  for 
all  by  the  experiments  of  A.  Lungwitz,  of  Dresden.  His 
conclusions  were  published  in  an  article  entitled  '  Changes 
in  Form  of  the  Hoof  under  the  Action  of  the  Body- weight.'* 

In  connection  with  this  it  is  interesting  to  note  how,  all 

*  Journal  of  Comparative  Pathology  and  Therapeutics,  vol.  iv., 
p.  191.  The  whole  of  the  matter  in  this  article,  from  which  we  have 
borrowed  Figs.  35  and  36,  is  too  long  for  reproduction  here.  It  forms, 
however,  most  instructive  reading,  and  its  careful  perusal  will  well 
repay  everyone  interested  in  this  most  important  question  (H.  C.  R.). 


GENERAL    OBSERVATIONS  63 

I.  c  d' 


Fig.  35. 
I.     Electric  Bell  with  Dry  Element. 

a,  Under  part,  with  box,  for  the  dry  element ;  b,  roller  for  winding- 
up  the  conducting  wires ;  c,  dry  element,  with  screw-clamp  for 
attachment  of  the  conducting-wires ;  c  ,  conducting-wire  leading 
to  the  screw-clamp,  with  contact-spring  in  c  ,  Fig.  2,  or  to  the 
wall  in  Fig.  3 ;  d,  upper  part,  with  bell ;  d',  conducting-wire  to  the 
shoe  d'  in  Figs.  2,  and  3 ;  e,  strap  for  slinging  the  apparatus 
around  the  body  of  the  assistant  or  rider ;  /,  connecting-wire 
between  bell  and  dry  element. 

II.  Hoof  Shod  with  Shoe  provided  with  Toe-piece  and  Calkins; 

Wall  of  the  Hoof  covered  with  Tinfoil. 
a,  Heel  angle,  with  b,  the  contact-screws ;  c,  screw-clamp,  with  con- 
tact-spring (isolated  from  the  shoe)  ;  c  conducting-wire  from  the 
same;  d,  screw-clamp,  with  conducting-wire  (d')  screwed  into 
edge  of  the  shoe;  e,  nails,  isolated  by  cutting  a  small  window 
in  the  tinfoil. 

III.  Hoof  Shod  with   Plain   Shoe;    Horny  Wall  covered  with 

Tinfoil. 

a,  Toe  and  heel  angle,  with  b,  the  contact-screws ;  c,  conducting-wire 
passing  from  the  tinfoil  on  the  wall;  d,  conducting-wire  passing 
from  the  shoe ;  c  ,  d' ' ,  ends  of  the  conducting-wires,  which  must 
be  imagined  connected  with  the  ends  c  ,  d' ',  passing  from  the 
apparatus. 

unconsciously,  two  separate  observers  were  simultaneously 
arriving  by  almost  identical  means  at  an  equally  satis- 
factory answer  to  the  question.     Prior  to  the  publication  of 


64 


DISEASES    OF    THE    HORSE'S    FOOT 


Lungwitz's  article  on  the  subject,  Colonel  F.  Smith,  A.V.D., 
had  arrived  at  similar  conclusions  by  working  on  the  same 
methods. 

It    is    unnecessary    for    our    purpose    here    to    minutely 
describe  the   exact   modus   operandi  of   these   two   experi- 


1  II. 

Fig.  36. 

I.     Left  Fore-foot  Shod  and  Mounted  to  recognize  the  Sinking 

of  the  Sole. 

a,  Iron  plate  covering  the  inner  half  of  the  horny  sole;  b,  openings  in 
the  same,  with  screw-holes  for  the  reception  of  the  contact-screw 
c  (the  part  of  the  sole  under  the  plate  is  covered  with  tinfoil, 
which  at  d  passes  out  under  the  outer  branch  of  the  shoe,  and 
becomes  connected  with  the  tinfoil  of  the  wall ;  in  order  to  give 
the  freshly  applied  tinfoil  a  better  hold,  copying-tacks  are  at  e 
passed  through  it  into  the  horn,  and  one  is  similarly  used  to 
protect  the  tinfoil  at  the  place  where  the  contact-screw  touches 
the  latter)  ■  /,  holes  with  screw  thread  for  the  fastening  of  the 
angle  required  to  measure  the  movement  of  the  wall,  and  also 
for  the  fastening  of  the  conducting-wire,  g ;  //,  conducting-wire 
passing  from  the  tinfoil;  i,  isolated  nails. 

II.     Bar-shoe  with  Openings. 

a,  Near  the  inner  margin  and  in  the  longitudinal  bar  ;  b,  for  the  recep- 
tion of  the  contact-screw  c;  d,  openings  for  fastening  the  angle 
and  the  conducting-wires. 


menters.     Briefly,  the  method  of  inquiry  adopted  in  each 
case  was  the  '  push  and  contact  principle  '  of  the  ordinary 
electric   bell,   and   the    close   attention   which   was   paid   to 
detail  will  be  sufficiently  gathered  from  Figs.  35  and  36. 
After  numerous  experiments  with  the  depicted  contact- 


GENERAL  OBSERVATK  )NS  65 

screws,    moved    to   the    various    positions   indicated   in    the 
drawings,  the  following  conclusions  were  arrived  at: 

1.  Behaviour  of  the  Coronary  Edge. — During  uniform 
weighting  of  all  four  hoofs  the  coronary  edge  shows  a 
tendency  to  contraction  in  the  anterior  and  lateral  regions 
of  the  hoof,  and  a  tendency  to  expansion  posteriori}-.  With 
heavy  weighting  of  the  hoof,  which  is  shown  by  a  backward 
inclination  of  the  fetlock,  contraction  in  the  anterior  and 
lateral  regions  is  slijht,  but  the  expansion  behind,  in  the 
region  of  the  heels,  is  distinct,  commencing  gradually  in 
front,  becoming  stronger,  and  diminishing  again  posteriorly. 
The  coronary  edge  of  the  heels  becomes  slightly  bulged 
outwards.  The  bulbs  of  the  heels  swell  up  and  incline  a 
little  backwards  and  downwards. 

When  the  fetlock  is  raised  the  expansion  of  the  coronary 
edge  of  the  heels  disappear  from  behind  forwards,  passing- 
forwards  like  a  fluid  wave.  In  the  lateral  and  anterior 
regions  of  the  coronary  edge  the  contraction  disappears  ; 
and  when  the  weight  is  thrown  oft"  the  foot  it  passes  into  a 
gentle  expansion  of  the  coronary  edge  of  the  toe.  During 
the  opposite  movement  of  the  fetlock,  that  of  sinking  back- 
wards, this  change  of  form  is  executed  in  the  converse 
manner. 

In  short,  the  contrary  edge  resembles  a  closed  elastic 
ring,  which  yields  to  pressure,  even  the  most  gentle,  of  the 
body-weight,  in  such  a  way  that  a  bulging  out  of  any  one 
part  is  manifested  by  an  inward  movement  of  another 
part. 

In  Fig.  37,  b,  the  dotted  line  represents  the  changes  of 
form  in  comparatively  well-formed  and  sound  hoofs  at  the 
moment  of  strongest  over-extensioir:  of  the  fetlock-joint. 

2.  Behaviour  of" the  Solar  Edge. — Under  the  action  of 
the  body-weight  this  is  somewhat  different  from  that  of 
the  coronary  edge.  Anteriorly,  and  at  the  sides,  as  far  as 
the  wall  forms  an  acute  angle  with  the  ground,  the  tendency 

*  The  term  "over-extension,'  as  employed  by  Lungwitz,  is  in- 
tended to  indicate  that  position  assumed  by  the  fetlock-joint 
when   the  opposite  foot  is   raised  from  the  ground. 


66         DISEASES    OF   THE    HORSE'S    FOOT 

to  expansion  exists,  but  the  change  of  form  first  becomes 
measurable  in  the  region  where  the  lateral  cartilages  begin. 
Quite  posteriorly  the  expansion  again  diminishes. 

Fig.  37,  a,  by  the  dotted  line  represents  the  expansion  at 
the  moment  of  over-extension  of  the  fetlock-joint.  This 
expansion  is  itself  rather  less  than  at  the  coronary  edge, 
and  it  shows  itself  distinctly  only  when  the  weighted  hoof  is 
exposed  to  a  counter-pressure  on  the  sole  and  frog,  no  mat- 
ter whether  the  counter-pressure  is  produced  naturally  or 
artificially.  Thus  anything  tending  to  the  removal  of  the 
pressure  from  below,  such  as  a  decayed  condition  of  the 
frog  or  excessive  paring  in  the  forge,  will  diminish  the 
extent  of  expansion  of  the  solar  edge. 

Contraction  of  the  solar  edge  of  the  heels  occurs  at  the 
moment  of  greatest  over-extension  of  the  fetlock-joint — 
that  is,  in  a  foot  with  pressure  from  below  absent.  On  the 
face  of  it,  this  appears  impossible.  Lungwitz,  however, 
has  perfectly  demonstrated  it;  and,  when  dealing  with  the 
functions  of  the  lateral  cartilages  in  a  later  paragraph,  we 
shall  show  reason  for  why  it  is  but  a  simple  and  natural 
result  of  the  foot  dynamics. 

3.  Behaviour  of  the  Sole. — The  horny  sole  becomes 
flattened  under  the  action  of  the  body-weight.  This  is 
most  distinct  at  the  solar  branches,  and  gradually  shades 
off  anteriorly  and  towards  the  circumference.  As  might 
be  supposed,  width  of  hoof  and  thickness  of  the  solar  horn 
exert  an  influence  on  the  extent  of  this  movement.  The 
sinking  of  the  horny  sole  is  most  marked  in  flat  hoofs. 

D.    THE  FUNCTIONS   OF   THE   LATEEAL   CABTILAGES.* 

We  have  just  referred  to  contraction  of  the  heels  as 
taking  the  place  of  a  normal  expansion  in  those  cases 
where  ground  frog-pressure  was  absent.  We  shall  readily 
understand  this  when  we  bear  in  mind  the  anatomy  of  the 
parts    concerned,    especially   that   of    the    plantar    cushion. 

*  Extracted  from  a  paper  by  J.  A.  Gilruth,  M.R.C.S.V.,  in  the 
Veterinary  Record,   vol.    i.,   p.   358. 


GENERAL    OBSERVATIONS 


67 


This  wedge-shaped  structure  we  have  already  described  as 
occupying  the  irregular  space  between  the  two  lateral 
cartilages,  the  extremity  of  the  perforans  tendon,  and  the 
horny  frog. 

Now,  when  weight  or  pressure  is  exerted  from  above  on 
to  this  organ,  and  the  frog  is  in  contact  with  the  ground 
below,  it  is  clear  from  the  position  the  cushion  occupies 
that,  whatever  change  of  form  pressure  from  above  will 
cause  it  to  take,  it  must  certainly  be  limited  in  various 
directions. 


Fig.  37. 

a,  The  dotted  lines  in  this  diagram  represent  the  expansion  of  the 
solar  edge  of  the  hoof  at  the  moment  of  over-extension  of  the 
fetlock-joint;  b,  the  dotted  line  represents  the  change  in  form 
of  the  coronary  edge  under  similfar  circumstances. 


Because  of  the  shape  of  the  cushion  its  change  of  form 
cannot  be  forwards  (simultaneous  pressure  from  above  and 
below  on  to  this  wedge  writh  its  apex  forwards  must  tend  to 
give  it  a  backward  change  of  form).  Because  of  the  pastern 
being  horizontal,  and  aiding  in  the  downward  pressure,  its 
change  of  form  cannot  be  upwards.  And  because  of  the 
ground  it  cannot  be  downwards.  It  follows,  therefore,  that 
the  movement  must  be  backwards  and  outwards,  being 
especially  directed  outwards  because  of  its  shape  and  the 
median  lacuna  in  its  posterior  half — this  latter,  the  lacuna, 


68  DISEASES  OE  THE  HORSE'S  EOOT 

accommodating  as  it  does  the  frog-stay,  preventing  the 
tendency  to  backward  movement  becoming  excessive,  and 
directing  the  change  of  form  to  the  sides.  Where  the 
greatest  pressure  is  transmitted,  then,  is  to  the  inner 
aspects  of  the  flexible  lateral  cartilages.  The  coronary 
cushion  being  continuous  with  the  plantar,  the  backward 
and  outward  movements  of  the  latter  will  tend  to  pull  upon 
and  tighten  the  former,  especially  in  front.  This  will 
account  for  the  contraction  noted  by  Lungwitz  in  the 
anterior  half  of  the  coronary  edge  of  the  hoof. 

Remove  the  body  weight,  and  naturally  the  elastic  nature 
of  the  lateral  cartilages  and  the  coronary  and  plantar  cush- 
ions, with,  in  a  less  degree,  that  of  the  hoof,  cause  things 
to  assume  their  normal  position. 

Repeat  the  weighting  of  the  hoof,  in  this  second  case 
without  frog-hressnre,  and  we  shall  see  at  once  that  we  have 
done  away  with  one  of  the  greatest  factors  in  determining 
the  outward  and  backward  movements  of  the  plantar 
cushion — namely,  the  pressure  from  below  on  its  wedge- 
shaped  mass.  The  movement  of  the  plantar  cushion  will 
now  be  downwards  as  well  as  backwards ;  and,  seeing  that 
it  is  attached  to  the  inner  aspect  of  each  lateral  cartilage, 
we  shall  expect  these  latter,  by  the  downward  movement  of 
the  plantar  cushion,  to  be  drawn  inwards.  This  Lungwitz 
has  shown  to  occur. 

The  chief  function  of  the  lateral  cartilages,  therefore,  is 
to  receive  the  concussion  engendered  by  locomotion,  which 
concussion  is  directed  backwards  and  outwards  by  the  pad- 
like plantar  cushion. 

In  addition  to  this,  the  lateral  cartilages,  together  with 
the  plantar  and  coronary  cushions,  play  the  part  of  a  valve 
to  the  zvliole  of  the  veins  of  the  foot. 

It  is  in  this  way  :  We  have  only  to  refer  to  the  chapter 
on  anatomy  to  see  that  the  whole  of  the  foot  is  covered 
with  a  tissue  of  extreme  vascularity.  Thus  we  find  papillae 
over  the  coronary  cushion ;  enlarged  and  modified  papillae 
— the  sensitive  laminae — covering  the  anterior  face  of  the 
os  pedis ;  and  a  numberless  papillae  again  covering  the  sole. 


GENERAL    OBSERVATIONS  69 

There  can  be  no  doubt  that  the  quantity  of  fluid  brought 
by  the  bloodvessels  of  these  papillae  to  the  foot  acts  largely 
as  a  means  of  hydraulic  protection  to  the  soft  structures.* 
In  like  manner  as  that  delicate  organ,  the  brain,  is  best 
protected  by  being  floated  upon  the  cerebro-spinal  fluid  and 
bloodvessels  (  which  fluids  transmit  waves  of  concussion  or 
pressure  through  the  organ  without  injury  to  the  delicate 
cells  forming  it),  so,  in  like  manner,  does  the  extreme 
vascularity  of  the  foot  protect  the  cells  of  its  softer  struc- 
tures from  the  effects  of  pressure  and  concussion. 

That  this  law  of  hydraulics  may  operate  in  the  horse's 
foot  to  the  best  advantage,  the  veins  must  be  provided  with 
valves,  and  valves  of  no  mean  strength.  These  we  know 
to  be  absent.  It  is  here  that  the  lateral  cartilages  and  the 
elastic  substances  of  the  coronary  and  plantar  cushions 
step  in  to  supply  the  deficiency. 

At  the  time  when  weight  is  placed  upon  the  foot  (with, 
of  course,  a  tendency  to  drive  the  blood  upwards  in  the 
limb),  and.  therefore,  the  time  when  a  valvular  apparatus 
is  needed  to  retain  the  fluid  in  the  foot,  we  find  the  want- 
ing conditions  supplied  by  the  pressure  outwards  of  the 
plantar  cushion  compressing  the  large  plexuses  of  veins  on 
each  side  of  the  lateral  cartilages,  to  which  plexuses,  it  will 
be  remembered,  the  bulk  of  the  venous  blood  from  the  foot 
was  directed.  A  more  perfect  valvular  apparatus,  auto- 
matic and  powerful,  it  would  be  difficult  to  imagine. 

E.    GROWTH  OF  THE  HOOF. 

We  will  conclude  this  chapter  with  a  few  brief  remarks 
on  the  growth  of  the  hoof.  That  the  rate  of  growth  is 
slow  is  a  well-known  fact  to  every  veterinarian,  and  it  will 
serve  for  all  practical  purposes  when  we  state  that,  roughly, 
the  growth  of  the  wall  is  about  %  inch  per  month.  This 
rate  is  regular  all  round  the  coronet,  from  which  it  follows 
that  the  time  taken   for  horn  to  grow   from  the  coronary 

*  The  Veterinary  Record,  vol.  iii..  p.  518. 


70         DISEASES    OF    THE    HORSE'S    FOOT 

edge  to  the  inferior  margin  will  vary  according  as  the  toe, 
the  quarters,  or  the  heels  are  under  consideration. 

As  might  naturally  be  expected,  the  rate  of  growth  will 
depend  on  various  influences.  Any  stimulus  to  the  secreting 
structures  of  the  coronet,  such  as  a  blister,  the  application 
of  the  hot  iron,  or  any  other  irritant,  results  in  an  in- 
creased growth.  Growth  is  favoured  by  moisture  and  by 
the  animal  going  unshod,  as  witness  the  effects  of  turning 
out  to  grass.  Exercise,  a  state  of  good  health,  stimulating 
diets — in  fact,  anything  tending  to  an  increased  circulation 
of  healthy  blood — all  lead  to  increased  production  of  horn. 
With  the  effects  of  bodily  disease  and  of  ill-formed  legs 
and  feet  on  the  wear  of  the  hoof,  and  the  growth  of  horn, 
we  shall  be  concerned  in  a  future  chapter. 


CHAPTEE  IV 
METHOD    OF   EXAMINING   THE   FOOT 

As  a  general  rule,  it  may  be  taken  that  most  diseases  of 
the  foot  are  comparatively  easy  of  diagnosis.  When,  how- 
ever, the  condition  is  one  which  commences  simply  with  an 
initial  lameness,  the  greatest  care  will  have  to  be  exercised 
by  the  practitioner. 

What  remarks  follow  here  should  rightly  be  confined  to 
a  treatise  on  lameness.  This  much,  however,  we  may 
state :  As  compared  with  lameness  arising  from  abnormal 
conditions  in  other  parts  of  the  limb,  that  emanating  from 
abnormalities  of  the  foot  is  easy  of  detection.  With  a  case 
of  lameness  before  him,  concerning  which  he  is  in  doubt, 
the  practitioner  remembers  that  a  very  large  percentage 
may  safely  be  referred  to  the  foot,  and,  if  wise,  subjects  the 
foot  to  a  rigorous  examination. 

Much  may  be  gathered  by  first  putting  the  animal 
through  his  paces.  When  at  a  trot,  notice  the  peculiarity 
of  the  '  drop,'  whether  any  alteration  in  going  on  hard  or 
soft  ground,  and  watch  for  any  special  characteristic  in 
gait.  At  the  same  time  inquiry  should  be  made  as  to  the 
history  of  the  case !  its  duration ;  whether  pain,  as  evi- 
denced by  lameness,  is  constant  or  periodic  ;  the  effect  of 
exercise  on  the  lameness ;  and  the  length  of  time  elapsed 
since  the  last  shoeing. 

This  failing  to  reveal  adequate  cause  for  the  lameness  in 
any  higher  part  of  the  limb,  one  is  led,  by  a  process  of 
negative  deduction,  to  suspect  the  foot. 


/I 


DISEASES    OF    THE    HORSE'S    FOOT 


If  '  pointing  '  is  a  symptom,  its  manner  is  noticed.  The 
foot  is  compared  with  the  other  for  any  deviation  from  the 
normal.  In  some  cases  the  two  fore  or  the  two  hind  feet 
may  differ  in  size.  Though  this  may  not  necessarily 
indicate  disease,  it  may,  nevertheless,  be  taken  into  account 
if  the  lameness  is  not  easily  referable  to  any  other  member. 
Measurement  with  calipers  will  then  be  of  help,  and  a 
pronounced  increase  in  size,  especially  if  marked  in  one 
position  only,  given  due  consideration.  The  hand  is  used 
upon  each  foot  alternately  to  look  for  change  of  tempera- 
ture, to  detect  the  presence  of  growths  small  enough  to 
escape  the  eye,  and  to  discover  evidence  of  painful  spots 
along  the  coronet. 

At  this  stage  the  method  of  percussion  recommends 
itself,  and  in  many  cases  no  more  useful  diagnostic  agent 
is  to  be  found  than  the  ordinary  hammer.  As  a  pre- 
liminary, the  foot  of  the  sound  limb  should  be  always 
tapped  first.  This  precaution  will  serve  to  bring  to  light 
what  is  frequently  met  with — the  aversion  nervous  animals 
sometimes  exhibit  to  this  manner  of  manipulation  of  the 
hoof.  Unless  this  is  done,  the  ordinary  objection  to  inter- 
ference is  apt  to  be  read  as  evidence  of  pain.  No  aversion  to 
the  method  being  shown,  the  suspected  foot  is  gently  tapped 
in  various  places  round  the  wall,  a  keen  look-out  being  kept 
for  any  manifestation  of  tenderness.  This  may  vary  from  a 
slight  resentment  to  each  tap,  indicated  by  a  sudden  lifting 
and  setting  down  again  of  the  foot,  to  a  complete  removal 
of  the  foot  from  the  ground,  and  a  characteristic  pawing  of 
the  air  that  points  out  clearly  enough  the  seat  of  pain. 

Evidence  of  pain  once  given,  the  tapping  is  persisted  in 
until,  in  some  cases,  the  exact  position  of  the  tender  spot 
is  definitely  located. 

Failing  evidence  obtained  from  percussion,  attention 
should  next  be  given  to  the  shoeing.  We  may  add  here 
that,  even  when  difficulties  have  to  be  encountered  in  doing 
it,  it  is  always  a  wise  plan  to  have  the  shoe  removed. 

The  nails  should  be  removed  one  by  one,  the  course 
they  have  taken,  their  point  of  emergence  on  the  wall,  and 


METHOD  OF  EXAMINING  THE  FOOT        73 

the  condition  of  their  broken  ends  all  being  carefully  noted 
as  they  are  withdrawn. 

The  removed  shoe  should  next  be  examined  as  to  the 
coarseness  or  fineness  of  its  punching  and  the  '  pitch  '  of 
its  nail-holes,  and  close  attention  given  to  the  shape  of  its 
bearing  surface. 

From  that  we  may  pass  to  a  consideration  of  the  under- 
neath surface  of  the  foot.  The  drawing-knife  should  he 
run  lightly  over  the  whole  of  its  surface,  the  first  thing  to 
he  noticed  being  the  point  of  entrance  of  the  nails  as 
compared  with  the  coarseness  or  fineness  of  the  punching, 
and  the  staining  or  otherwise  of  the  horn  immediately 
around.  We  may  thus  be  guided  towards  mischief  arising 
from  tight  nailing  apart  from  actual  prick  of  the  foot. 

This  done,  more  than  usual  care  should  be  taken  in 
following  up  any  other  small  prick  or  dark  spot  that  may 
show  itself  upon  the  white  surface  of  the  cleaned  sole.  In 
any  case,  a  suspicious-looking  speck  should  be  followed  up 
with  the  searcher  until  it  is  either  cut  out  or  is  traced  to 
the  sensitive  structures. 

AYhile  this  is  done,  we  should  also  have  noticed  the 
condition  of  the  horn  at  the  seat  of  corn ;  should  have 
noticed  the  shape  of  the  heels,  contracted  or  otherwise ; 
and  the  appearance  of  the  frog,  clean  or  discharging. 

A  point  to  be  remembered  in  making  this  exploratory 
paring  of  the  foot  is  the  peculiar  consistency  of  .the  horn 
of  the  frog,  and  its  tendency  to  hide  the  existence  of 
punctures.  In  like  manner,  as  a  pin  pierces  a  piece  of 
indiarubber,  and  leaves  no  clearly  visible  trace  of  the  hole 
it  has  made,  so  does  a  nail  or  other  sharp  object  penetrate 
the  frog,  leaving  but  little  to  show  for  the  mischief  that 
has  been  done. 

After  all,  even  though  we  may  have  fully  decided  the 
foot  is  at  fault,  our  case  of  lameness  may  remain  obscure  so 
far  as  a  cause  is  concerned.  Nothing  remains,  then,  but  to 
acknowledge  the  inability  to  discover  it,  to  advocate  poul- 
ticing, or  some  other  expectant  palliative  measure,  and  to 
bring  the  case  up  for  further  examination  at  no  distant  date. 


74         DISEASES    OF   THE    HORSE'S    FOOT 

Where,  though  we  may  have  suspected  the  foot,  we  have 
not  been  able  to  definitely  assure  ourselves  that  there  the 
mischief  is  to  be  found,  a  further  method  of  examination 
presents  itself — namely,  subcutaneous  injections  of  cocaine 
along  the  course  of  the  plantar  nerves. 

The  salt  of  cocaine  used  is  the  hydrochlorate,  2\  grains 
for  a  pony,  4  grains  for  a  medium-sized  animal,  and  6 
grains  for  a  large  horse.  A  solution  of  this  is  made  in 
boiled  water  (about  3  drams),  and  injected  at  the  seat  of 
the  lower  operation  of  neurectomy. 

It  is  advisable  to  first  render  aseptic  the  seat  of  opera- 
tion, and  to  sterilize  both  the  needle  and  the  syringe  by 
boiling.  A  suitable  point  to  choose  for  the  injection  is 
exactly  over  the  upper  border  of  the  lateral  faces  of  the 
two  sesamoids,  the  needle  being  introduced  behind  the  cord 
formed  by  the  nerve  and  accompanying  vessels,  and  parallel 
with  it. 

It  is  possible  that  the  vein  or  the  artery  may  be  wounded, 
but  such  accident  is  of  little  importance.  All  that  is  neces- 
sary in  that  case  is  to  partly  withdraw  the  needle  and  again 
insert  it.     It  is  advisable  to  use  a  twitch. 

When  the  needle  is  in  position,  the  injection  should  be 
made  slowly,  and  at  the  same  time  the  point  of  the  needle 
should  be  made  to  describe  a  semicircular  sweep,  so  as 
to  spread  the  solution  over  as  wide  an  area  as  is  possible. 

Anaesthesia  ensues  in  from  six  to  twenty  minutes,  and  if 
the  cause  of  the  lameness  is  below  the  point  of  injection 
the  animal  moves  sound. 

Regarding  this  method  of  diagnosis,  Professor  Udriski 
of  Bucharest,  after  a  series  of  trials,  sums  up  as  follows : 

1.  For  the  diagnosis  of  lameness  cocaine  injections  are 

of  very  considerable  value. 

2.  These  injections  should  be  made  along  the  course  of 

the  nerves. 

3.  Solutions  heated  to  40°   or  50°  C.  produced  quicker, 

deeper,  and  longer  anaesthesia  than  equally  strong 
cold  solutions. 

4.  In  the  sale  of  horses  cocaine  injections  conceal  fraud. 


METHOD    OF    EXAMINING    THE    FOOT      75 

Cocaine  being  an  irritant,  it  must  be  remembered  that 
after  the  anaesthesia  the  lameness  is  somewhat  more  marked 
than  before. 

To  the  cocaine  other  practitioners  add  morphia  in  the 
following  proportions : 

Cocaine    hydrochlorate    ...  ...      2\  grains. 

Morphia  .'. H       " 

Acqua  destil.       ...  ...  ...      H  drams. 

As  a  diagnostic  this  mixture  of  the  two  is  said  to  be  far 
superior  to  either  cocaine  or  morphia  alone. 

In  connection  with  this  subject,  Professor  Hobday  has 
published,  among  others,  the  following  cases  illustrating 
the  practical  value  of  this  method  of  diagnosis  :* 

Case  /. — Cab  gelding.  Seat  of  lameness  somewhat 
obscure;  navicular  disease  suspected.  Injected  2  grains 
of  cocaine  in  aqueous  solution  on  either  side  of  the  limb, 
immediately  over  the  metacarpal  nerves. 

Five  Minutes. — Lameness  perceptibly  diminished. 

Ten  Minutes. — Lameness  scarcely  perceptible. 

Case  77. — Mare.  Obscure  lameness ;  foot  suspected. 
Injected  30  minims  of  a  5  per  cent,  solution  on  either  side 
of  the  leg  just  above  the  fetlock. 

Ten  minutes. — No  lameness,  thus  proving  that  the  seat 
of  lameness  was  below  the  point  of  injection. 

Case  III. — Cab  gelding,  aged,  free  clinique :  Messrs. 
Elme's  and  Moffat's  case.  Obscure  lameness ;  foot  sus- 
pected of  navicular  disease ;  very  lame.  Injected  30 
minims  of  a  5  per  cent,  solution  of  cocaine  on  either  side 
of  the  leg  over  the  metacarpal  nerves. 

Six  Minutes. — Lameness  perceptibly  less;  there  was  no 
response  whatever  on  the  inside  of  the  leg  to  the  prick 
of  a  pin.  On  the  outside,  which  had  not  been  injected  so 
thoroughly,  there  was  sensation,  although  not  so  much  as 
in  a  healthy  foot. 

Ten    Minutes. — Lameness    had    almost    disappeared;    so 

*  The  Journal  of  Comparative  Pathology  and  Therapeutics,  vol. 
viii.,  pp.  27,  43. 


76         DISEASES    OF   THE   HORSE'S    FOOT 

much  so,  that  the  opinion  as  to  navicular  disease  was  con- 
firmed, and  neurectomy  was  performed.  Immediately  after 
this  operation  there  was  no  lameness  whatever. 

The  same  author  also  reports  numerous  cases  among 
horses  and  cattle,  dogs  and  cats,  pointing  out  the  toxic 
properties  of  the  drug.  The  symptoms  following  an  over- 
dose are  interesting  enough  to  relate  here,  and  I  select 
the  following  case  of  Professor  Hobday's  as  being  fairly 
typical  :* 

Case  IV. — Cart  gelding.  Free  clinique;  navicular 
disease.  Injected  subcutaneously  over  the  metacarpal 
nerves  on  each  side  6  grains  of  cocaine  in  aqueous  solution. 
During  the  operation  the  animal  manifested  no  signs  of 
pain  whatever,  not  even  when  the  nerve  was  cut.  This 
animal  received  altogether  12  grains  of  cocaine  (3  grains 
were  given  on  either  side  first,  then  fifteen  minutes  after- 
wards the  same  dose  repeated).  The  effect  was  manifested 
on  the  system  in  ten  minutes  after  the  second  injection  by 
clonic  spasms  of  the  muscles  of  the  limbs  (the  legs  being 
involuntarily  jerked  backwards  and  forwards  at  intervals  of 
about  twenty  seconds),  which  materially  interfered  with 
the  performance  of  the  operation.  The  animal  was  also 
continually  moving  the  jaws,  and  was  very  sensitive  to 
sounds,  moving  the  ears  backwards  and  forwards.  This 
hyperesthesia,  as  evinced  by  the  movement  of  the  ears, 
lasted  for  some  considerable  time  after  the  animal  had  been 
allowed  to  get  up. 

Cocaine  hydrochlorate  solutions,  if  intended  to  be  kept 
for  any  length  of  time,  should  have  added  to  them  when 
freshly  made  1/200  part  of  boric  acid  in  order  to  preserve 
them.  Even  then  they  are  liable  to  spoil,  and  should,  for 
subcutaneous  injection,  be  made  up  just  before  needed 
for  use. 

*  hoc.  cit. 


CHAPTEE  V 

GENERAL  REMARKS  ON  OPERATIONS  ON  THE 

FOOT 

A.  METHODS    OF    RESTRAINT. 

Many  of  the  simple  operations  on  the  foot,  such  as  the 
probing  of  a  sinus,  the  paring  out  of  corns,  or  the  search- 
ing of  pricks,  may  most  suitably  be  performed  with  the 
animal's  leg  held  by  the  operator  as  a  smith  holds  it  for 
shoeing.  According  to  the  temperament  of  the  animal, 
e\en  the  operation  for  the  removal  of  a  portion  of  the  sole, 
or  the  injection  of  sinuses  with  caustics,  may  be  carried 
out  with  the  animal  simply  twitched. 

When  the  operation  is  still  a  simple  one,  casting  incon- 
venient or  impossible,  and  the  animal  restive,  the  twitch 
must  be  supplemented  by  some  other  method.  The  most 
simple  and  one  of  the  most  effective  is  the  blind,  cap,  or 
bluff  (Fig.  38").  With  it  the  most  vicious  animal  or  the 
most  nervous  is  in  many  instances  either  cowed  into  sub- 
mission or  soothed  into  quietness. 

At  the  same  time,  more  forcible  means  than  the  opera- 
tor's own  strength  must  be  taken  to  hold  the  animal's  foot 
from  the  ground.  If  the  foot  is  a  fore-foot,  and  the  point 
desired  to  be  operated  on  is  to  the  outside,  the  pastern 
should  be  firmly  lashed  to  the  forearm  by  means  of  a  thin, 
short  cord,  or  a  leather  strap  and  buckle.  Much  may  then 
be  done  in  the  way  of  paring  and  probing  that  would 
otherwise  be  impossible. 

If  the  foot  is  a  hind  one,  one  of  the  many  methods  of 

77 


78 


DISEASES    OF   THE    HORSE'S    FOOT 


using  what  is  termed  by  Liautard,  in  his  '  Manual  of 
Operative  Veterinary  Surgery,'  the  plate-longe,  must  be 
adopted.     This,   in   its   most   useful   form,   is   a   length   of 


Fig.  38.— The  Blind. 

closely-woven  cotton  webbing,  from  about  2  to  2\  inches 
wide,  and  from  5  to  6  yards  long,  provided  with  a  small 
loop  formed  on  one  of  its  ends,  and  perhaps  better  known 


mm 

Fig.  39.— The  Side-line. 


to   English   readers   as   a   '  side-line.'      If   webbing   be   not 
available,  a  length  of  soft  cotton  rope,  or  a  rope  plaited 
and  sold   for  the  purpose,   as  Fig.  39,  will  serve  equally 


OPERATIONS    ON    THE    FOOT 


79 


Fig.    40. — The    side-line    adjusted    preparatory    to    securing    the 
Near  Hind-foot. 


. 


Fig.   41. — The   Near   Hind-foot   secured   with   the   Side-line, 


80         DISEASES    OF    THE   HORSE'S    FOOT 

well.  One  of  the  most  convenient  methods  of  using  the 
side-line  for  securing  the  hind-foot  is  depicted  in  Figs.  40 
and  41. 

Here  the  side-line  has  formed  upon  it  a  loop  sufficiently 
large  to  form  a  collar.  This  is  placed  round  the  animal's 
neck,  the  free  end  of  the  line  run  round  the  pastern  of  the 
desired  foot,  and  the  foot  drawn  forward,  as  in  Fig.  40. 

The  loose  end  of  the  line  is  then  twisted  once  or  twice 
round  the  tight  portion,  and  finally  given  to  an  assistant  to 
hold  (see  Fig.  41).  The  foot  is  thus  held  from  the  ground, 
and  violent  kicking  movements  prevented. 

Where  the  operation  is  a  major  one,  restraint  of  a  dis- 
tinctly more  forcible  nature  becomes  imperative.     Many  of 


Fig.  42.— Casting  Hobbles. 

the  more  serious  operations  can  most  advantageously  be 
performed  with  the  patient  secured  in  some  form  or  other 
of  stock  or  trevis,  and  the  foot  suitably  fixed.  It  is  not 
the  good  fortune  of  every  veterinary  surgeon,  however,  to 
be  the  lucky  possessor  of  one  of  these  useful  aids  to  suc- 
cessful operating.  Perforce,  he  must  fall  back  on  casting 
with  the  hobbles  (Fig.  42). 

With  the  use  of  these  we  will  assume  our  readers  to  be 
conversant,  and  will  imagine  the  animal  to  be  already  cast. 
It  remains,  then,  but  to  detail  the  most  suitable  means  for 
firmly  fixing  the  foot  to  be  operated  on. 

Here  the  side-line  is  again  brought  into  use.  Care  should 
previously   have   been   taken   when   casting   to   throw   the 


OPERATIONS    OX    THE    FOOT 


81 


animal  so  that  the  portion  of  the  foot  to  be  operated  on, 
whether  inside  or  outside,  falls  uppermost,  and  that  the 
buckle  of  the  hobble  on  that  particular  foot  is  placed  so 
that  it  also  is  within  easy  reach  when  the  animal  is  down. 

In  the  case  we  are  illustrating  the  point  of  operation  was 
the  outside  of  the  near  hind  coronet.  We  will,  therefore, 
describe  the  mode  of  fixing  the  near  hind- foot  upon  the 
cannon  of  the  near  fore-limb. 

The  side-line  is  first  adjusted  as  follows:  It  is  fixed  upon 
the  cannon  of  the  near  hind-leg  (A)  by  means  of  its  small 


Fig.    43. — Photograph    illustrating    Method    of    adjusting    the 
Side-line  preparatory  to  fixing  the  Hind-leg  upon  the  Fore. 


loop.  From  there  it  is  passed  under  the  forearm  of  the 
same  limb,  over  the  forearm,  under  the  rope  running  from 
A  to  B ;  from  there  over  and  under  the  thigh,  to  be  finally 
brought  in  front  of  the  thigh,  and  below  the  portion  of  rope 
running  from  arm  to  thigh.  The  loose  end  of  the  side-line 
is  then  given  to  an  assistant  standing  behind  the  animal's 
back,  the  buckle  of  the  hobble  restraining  the  foot  unloosed, 
and  strong  but  steady  traction  brought  to  bear  from  behind 
upon  the  line. "  The  operator  should  now  stand  in  front  of 
the  fore-limbs,  and,  by  placing  a  hand  on  the  rope  passing 


82 


DISEASES    OF    THE    HORSE'S    FOOT 


round  the  arm,  prevent  the  line   from  slipping  below  the 
knee. 

By  this  means  the  hind-limb  is  pulled  forward  until  the 
foot  projects  beyond  the  cannon  of  the  front-limb.  When 
that  position  is  reached,  the  operator  grasps  the  hock  firmly 
with  one  hand,  and,  directing  the  side-line  to  be  slackened, 
gently  slides  downward  the  coils  of  rope  round  the  arm 
and  thigh  until  they  encircle  the  cannons  of  both  limbs. 
The  cannon  of  the  hind-limb  is  firmly  lashed  to  the  cannon 
of  the  fore,  and  the  foot  firmly  and  securely  fixed  in  the 
best  position  for  operating   (see  Fig.  44). 


Fig.  44. — Photograph  showing  the  Near  Hind-foot  Secured  upon 
the   Cannon  of  the   Near  Fore-limb. 


Similarly,  with  the  horse  still  on  his  off  side,  the  off  hind- 
liinb  may  be  fixed  to  the  near  fore,  and  the  near  fore  and 
the  off  fore  to  the  near  hind. 

With  the  animal  on  his  near  side,  we  may  fix  the  near 
hind  and  the  off  hind  to  the  off  fore,  and  the  off  fore  and 
near  fore  to  the  near  hind. 

The  points  to  be  remembered  in  fixing  the  limbs  thus 
are :  ( 1 )  The  side-line  should  always  commence  upon  the 
cannon  of  the  limb  to  be  operated  on;  (2)  it  should  next 
pass  under  and  over  (or  over  and  under,  it  is  immaterial 
which)  first  the  arm  and  then  the  thigh,  or  the  thigh  and 


OPERATIONS    ON    THE    FOOT  83 

the  arm,  as  the  case  may  be;  (3)  in  every  case,  whether 
rounding  the  thigh  and  the  arm  from  above  or  below,  the 
piece  of  rope  completing  the  round  should  always  finish 
below  that  portion  preceding  it,  so  that  traction  upon  it  from 
behind  the  animal's  back  should  tend  to  keep  all  portions 
of  it  from  slipping  below  the  knee  and  the  hock. 

With  the  uppermost  fore-limb  secured  to  the  hind-limb 
in  the  manner  we  have  described,  we  have  the  underneath 
fore-limb  suitably  exposed  for  both  the  higher  and  lower 
operations  of  neurectomy.  The  position  for  this  operation 
will  be  made  better  still  if  the  lowermost  limb  (the  one 
to  be  operated  on)  is  removed  from  the  hobbles  and  drawn 
forward  by  an  assistant  by  means  of  a  piece  of  rope 
fastened  to  the  pastern. 

Taking  what  we  have  described  as  a  general  guide,  other 
modifications  of  thus  securing  the  foot  will  suggest  them- 
selves to  the  operator  to  meet  the  special  requirements 
of  the  case  with  which  he  is  dealing. 

Regarding  the  administration  of  chloroform,  no  descrip- 
tion of  the  method  is  needed  here,  as  it  will  be  found  fully 
detailed  in  most  good  works  on  general  surgery.  Where 
great  immobility  is  needed,  it  is  one  of  the  most  valuable 
means  of  restraint  we  have.  Apart  from  that,  its  use  in 
any  serious  operation  is  always  to  be  advocated,  if  only  on 
the  score  of  humane  consideration  for  the  dumb  animal 
helpless  under  our  hands. 

B.  INSTBUMENTS  REQUIRED. 

In  addition  to  those  required  for  operations  on  the  softer 
structures — such  as  scalpels,  forceps,  artery  forceps,  direc- 
tors, scissors,  etc. — the  surgery  of  the  foot  demands  instru- 
ments specially  adapted  for  dealing  with  the  horn. 

A  great  deal  will  depend  upon  the  operator  as  to  whether 
these  are  few  or  many.  The  average  man  of  resource  will 
deem  a  smith's  rasp  and  one  or  two  strong  drawing-knives 
amply  sufficient,  and  on  no  account  should  they  be  omitted 
from  the  list  of  those  readv  to  hand. 


84 


DISEASES    OF    THE    HORSE'S    FOOT 


The   ordinary   smith's   drawing-knife    (Fig.   45)    is   well 
known  to  almost  everyone,  and  is  well  suited  for  much  of 


''mm 


Fig.  45. — The  Ordinary  Drawing-knife. 

the  rougher  part  of  the  work.     The  careful  following  up 
of  pricks,  however,  and  some  of  the  more  special  operations 


1 1 


Jl 


a  1>  c  a 

Fig.  46. 

a,  b,  Modern  forms  of  drawing-knife;  c,  d,  e,  sage-knives. 


demanding  removal  of  portions  of  the  lateral  cartilages  call 
for  instruments  of  a  more  delicate  character  and  peculiar 


OPERATIONS  ON  THE  FOOT 


85 


construction.  These  are  to  be  found  in  the  so-called  sage- 
knife,  and  the  modern  (French)  pattern  of  drawing-knife. 

The  modern  drawing-knife  differs  from  the  smith's 
instrument  in  being  attached  to  a  straight,  instead  of  a 
curved,  handle,  and  in  usually  being  sharp  on  both  edges 
instead  of  only  one.  These  are  made  in  various  sizes 
(Fig.  46,  a,  b),  and  the  blades  fiat,  curved  on  the  flat,  or 
curved  at  an  angle  with  the  edges  of  the  haft. 

The  sage-knife,  as  its  name  indicates,  is  a  knife  with 
a  lanceolate-shaped  blade.  These  also  may  be  obtained 
in  varying  forms  and  sizes  (Fig.  46,  c,  d,  e).  Fig  46,  c,  is  a 
single-edged,  right-handed  sage  knife.     Fig.  46,  d,  is  a  left- 


Fig.  47. — Symen's  Abscess-knife. 


handed  instrument  of  the  same  type.  The  double-edged 
sage-knife  is  represented  in  Fig.  46,  c. 

It  may  be  mentioned  too,  in  passing,  that  the  ordinary 
Symes's  abscess-knife  (Fig.  47)  is  a  most  useful  instrument 
when  performing  the  operation  of  partial  excision  of  the 
lateral  cartilages,  its  peculiar  shape  lending  itself  admirably 
to  the  niceties  of  the  operation. 

One  or  two-good  shaped  firing-irons  will  also  be  found 
useful.  They  will  lighten  the  labor  of  tediously  excavat- 
ing grooves  with  the  knife,  where  that  procedure  is  neces- 
sary ;  and,  used  in  certain  positions  to  be  afterwards  de- 
scribed, will  afford  just  that  necessary  degree  of  stimulus 
to  the  horn-secreting  structures  of  the  foot,  which  the  use 
of  the  knife  alone  will  not. 

The  man  in  country  practice  will  also  be  well  advised  in 


86  DISEASES  OF  THE  HORSE'S  FOOT 

carrying  to  every  foot  case  a  compact  outfit,  such  as  that 
carried  by  the  smith.  This  will  consist  of  hammer  and 
pincers,  drawing-knife  and  buffer.  Much  valuable  time  is 
then  often  saved  which  would  otherwise  be  wasted  in 
driving  round  for  the  nearest  smith. 

There  are  other  special  operations  requiring  the  use  of 
specially-devised  instruments  for  their  successful  carrying 
out-  These  we  shall  mention  when  we  come  to  a  con- 
sideration of  the  operation  in  which  they  are  necessary. 

C.    THE  APPLICATIONS   OF  DRESSINGS. 

One  of  the  most  common  methods  of  applying  a  dressing 
to  the  foot  is  poulticing.  Usually  resorted  to  on  account 
of  its  warmth-retaining  properties,  the  poultice  may  also 
be  medicated.  In  fact,  a  poultice,  strongly  impregnated 
with  perchloride  of  mercury  or  other  powerful  antiseptic, 
is  a  useful  dressing  in  a  case  of  a  punctured  foot,  or  a 
wise  preliminary  to  an  operation  involving  the  wounding 
of  the  deeper  structures.  The  poultice  may  consist  of  any 
material  that  serves  to  retain  heat  for  the  longest  time. 
Meal  of  any  kind  that  contains  a  fair  percentage  of  oil  is 
suitable.  Crushed  linseed,  linseed  and  bran,  or  linseed- 
cake  dust  are  among  the  best. 

To  prepare  it,  all  that  is  necessary  is  to  partly  fill  a 
bucket  with  the  material  and  pour  upon  it  boiling  water. 
The  hot  mass  is  emptied  into  a  suitable  bag,  at  the  bottom 
of  which  it  is  wise  to  first  place  a  thin  layer  of  straw,  in 
order  to  prevent  the  bag  wearing  through,  and  then  secured 
round  the  foot  This  is  generally  done  by  means  of  a  piece 
of  stout  cord,  or  by  straps  and  buckles  fastened  round  the 
pastern  and  above  the  fetlock. 

An  improved  method  of  fastening  has  been  devised  by 
Lieutenant-Colonel  Nunn : 

'  A  thin  rope  or  stout  piece  of  cord  about  5  feet  long  is 
doubled  in  two,  and  a  knot  tied  at  the  double  end  so  as  to 
form  a  loop  about  5  or  6  inches  long,  this  length  depending 
on  the  size  of  the  foot  (as  at  A,  Fig.  48).  The  poultice  or 
other  dressing  is  applied  to  the  foot,  and  the  cloth  wrapped 


OPERATIONS  OX  THE  FOOT 


87 


round  in  the  ordinary  way,  the  loop  of  the  cord  being 
placed  at  the  back  of  the  pastern  (as  in  A,  Fig.  49)  ;  the 
ends  of  the  cord  are  passed  round,  one  on  the  inside  and 
the  other  on  the  outside,  towards  the  front  fas  in  B,  Fig.  4(> ) . 
These  ends  are  then  twined  together  down  as  far  as  the 
toe  (see  C  in  Fig.  49  ).     The  foot  is  now  lifted  up,  and  the 

E\\  HE 


Fig   48. 


Fig.    49. 


Fig.    50.  Fig.   51. 

Figs.    48,    49,    50,    51. — Illustrating    Lieutenant-Colonel    Nunn's 
Method  of  applying  a  Poultice  to  the  Foot. 

ends  of  the  cord  (CC,  Fig.  49  ),  are  passed  through  the  loop 
A  (as  at  D,  Fig.  49),  and  then  drawn  tight.  The  ends  of  the 
cord  are  now  separated,  and  carried  up  to  the  coronet  ( as  at 
FE,  Fig.  49),  one  on  the  outside,  the  other  on  the  inside  of 
the  foot.  They  are  then  again  twisted  round  each  other  once 
or  twice  (as  at  F,  Fig.  50),  and  are  passed  round  the  pastern 
once  or  twice  on  each  side.     They  are  now  passed  under 


88 


DISEASES  OF  THE  HORSE'S  FOOT 


the  cord  ( E,  Fig.  49),  and  then  reversed,  so  as  to  tighten 
up  E,  and  are  finally  tied  round  the  pastern  in  the  usual 
manner.  The  arrangement  of  the  cords  on  the  sole  is 
shown  in  Fig.  51,  which  is  a  view  from  the  posterior  part. 

4  The  advantages  of  this  method  of  fastening  have  been 
found  to  be  :  (1  )  It  does  not  chafe  the  skin  ;  (2)  if  properly 
applied  it  has  never  been  known  to  come  undone;  (3)  it 
is  the  only  way  we  know  that  a  poultice  can  be  satisfac- 
torily applied  to  a  mule's  hind-foot:  (4)  horses  can  be 
exercised  when  the  poultice  is  on  the  foot,  which  is  almost 


Figs.  52,  53.— Two  Forms  of  Poultice-boot. 

impossible  with  the  ordinary  leather  boot ;  ( 5  )  the  sacking 
or  canvas  does  not  cut  through  so  quickly.' 

A  further  method  of  applying  the  poultice  is  by  using 
one  of  the  poultice-boots  made  for  that  purpose  (see  Figs. 
52  and  53). 

These  have  an  objection.  They  are  apt  to  be  allowed  to 
get  extremely  dirty,  and  so,  by  carrying  infective  matter 
from  the  foot  of  one  animal  to  that  of  another,  undo  the 
good  that  the  warmth  of  the  poultice  is  bringing  about. 
The  advantage  of  the  ordinary  sacking  or  canvas  is  that  it 
may  be  cast  aside  after  the  application  of  each  poultice. 


OPERATIONS  ON  THE  FOOT  89 

Where  the  boot  is  kept  clean,  however,  it  will  save  a  great 
deal  of  time  and  trouble  to  the  attendant. 

While  on  the  subject  of  poulticing,  it  is  well  to  remark 
that  in  many  cases  it  may  be  more  advantageous  to  supply 
the  necessary  warmth  and  moisture  to  the  foot  by  keeping 
it  immersed  in  a  narrow  tub  of  water  maintained  at  the 
required  temperature.  By  this  means  the  warmth  is  car- 
ried further  up  the  limb  (sometimes  an  important  point), 
and  the  water  can  more  conveniently  be  medicated  with 
whatever  is  required  than  can  the  poultice.  In  fact,  it  is 
the  author's  general  practice,  where  the  attendants  can  be 
induced  to  take  the  necessary  pains,  to  always  advise  this 
latter  method. 


Fig.  54. — Swab  for  applying  Moisture  to  the  Foot. 

Where  a  dressing  is  relied  upon  by  some  practitioners 
on  account  of  the  warmth  it  gives,  others,  even  in  identical 
cases,  will  depend  upon  the  effects  of  cold.  This  may  be 
applied  by  means  of  what  are  called  '  swabs.'  In  their 
simplest  form  swabs  may  consist  only  of  hay-bands  or 
several  layers  of  thick  bandage  bound  round  the  foot  and 
coronet,  and  kept  cool  by  having  water  constantly  poured 
upon  them.  In  many  cases  the  form  of  swab  depicted  in 
Fig.  54  will  be  found  more  convenient. 

When  only  one  foot  is  required  to  be  dressed,  and  a 
water-supply  is  available,  by  far  the  preferable  method  is 
to  attach  one  end  of  a  length  of  rubber  tubing  to  the  water- 
tap,  and  fasten  the  other  just  above  the  coronet,  allowing 
the  water  to  trickle  slowly  over  the  foot.  In  cases 
where  a  forced  water-supply  is  unobtainable,  and  the  case 


90 


DISEASES  OF  THE  HORSE'S  FOOT 


warrants  the  extra  trouble,  much  may  be  done  with  a 
medium-sized  cask  of  water  placed  somewhere  over  the 
animal,  and  the  rubber  tubing  connected  with  that. 

Where  the  dressing  is  desired  to  be  kept  applied  to  the 
sole  and  frog  only,  there  is  no  method  more  satisfactory 
than  the  shoe  with  plates. 


B 

Fig.    55.— The   Shoe    with   Plates. 

A,  The  plates  in  position  ;  B,  the  plates  separated  from  the  shoe. 

The  plates  are  of  metal,  preferably  of  thin  sheet  iron 
or  zinc,  and  are  slipped  between  the  upper  surface  of  the 
shoe  and  the  foot  after  the  manner  shown  in  Fig.  55.  The 
plates  themselves  are  shaped  as  depicted  in  Fig.  55,  a,  b,  c, 
a  and  b  curved  to  meet  the  outlines  of  the  shoe,  and  r 
shaped  so  as  to  wedge  tightly  over  the  posterior  ends  of  the 


jfegs&bi 


H 


Fig.  56.— The  Quittor  Syringe. 


side  plates,  and  between  them  and  the  shoe.  A  distinct 
advantage  of  the  plate  method  of  dressing  is  that  a  certain 
amount  of  pressure  may  be  maintained  on  the  sole  and  frog, 
a  very  important  consideration  in  connection  with  some  of 
the  diseases  with  which  we  shall  later  deal. 


OPERATIONS  OX  THE  FOOT  91 

When  dealing  with  sinuous  wounds  of  the  foot  another 
favourite  mode  of  applying  dressings  is  by  means  of  the 
syringe,  and  no  better  instrument  for  all  cases  can  be  found 
than  that  known  as  a  quittor  syringe  ( Fig.  56  ) . 

A  further  mode  of  applying  dressing,  and  one  frequently 
practised  in  connection  with  the  foot,  is  known  as  '  plug- 
ging.' This  is  almost  sufficiently  indicated  by  its  name.  It 
consists  in  rolling  portions  of  the  dressing  into  little  cylin- 
ders, wrapped  round  with  thin  paper,  and  introduced  into 
a  sinus  or  other  position  where  considered  necessary. 

D.    PLANTAR  NEURECTOMY. 

As  a  last  resort  in  the  treatment  of  many  diseases  of  the 
foot  the  operation  of  neurectomy  is  often  advised.  It  will 
be  wise,  therefore,  to  insert  a  description  of  the  opera- 
tion here. 

Derivation  of  the  Word. — For  many  years  the  operation 
was  known  simply  as  '  nerving  '  or  '  unnerving,'  and  it  was 
not  until  1823,  at  the  suggestion  of  Dr.  George  Pearson, 
that  Percival  introduced  the  word  neurotomy  to  signify  the 
operation  with  which  we  are  now  about  to  deal.  The  word 
neurotomy,  however,  used  strictly,  means  the  act  or  practice 
of  dissection  of  nerves,  and,  when  applied  to  the  operation 
as  practised  to-day,  describes  only  a  step  in  the  procedure. 

As  the  operation  really  consists  in  cutting  down  upon, 
and  afterwards  excising  a  portion  of  the  nerve,  the  modern 
appellation  of  neurectomy — from  the  Greek  neuron,  a 
nerve;  and  tome,  a  cutting,  signifying  the  cutting  out  of  a 
nerve  or  the  portion  of  a  nerve — is  far  more  suitable. 

According  as  the  nerve  operated  on  is  the  plantar  or 
the  median,  the  operation  is  known  as  plantar  or  median 
neurectomy. 

History  of  the  Operation. — It  is  to  two  English  veteri- 
narians that  we  owe  the  introduction  of  the  operation  to 
the  veterinary  world.  In  1819  Professor  Sewell  announced 
himself  as  the  originator  of  neurotomy.  This  claim  was 
disputed  by  Moorcraft,  who  appears  to  have  successfully 
shown    himself    to    be    the    real    person    entitled    to    that 


92  DISEASES  OF  THE  HORSE'S  FOOT 

honour,  he  having  satisfactorily  performed  the  operation 
on  numerous  animals  for  fully  eighteen  years  prior  to 
Professor  Sewell's  announcement.  It  appears  that  Moor- 
craft  left  this  country  for  India  in  1808,  having  practised 
the  operation  in  more  or  less  obscurity  for  some  six  or 
seven  years  previous  to  that.  After  his  departure  neurec- 
tomy, as  introduced  by  him,  either  died  away  in  repute, 
or  was  not  made  by  him  sufficiently  public  to  become  a 
matter  of  general  knowledge.  To  Professor  Sewell,  there- 
fore, although  not  the  actual  originator  of  the  operation, 
belongs  the  honour  of  making  it  public  to  the  veterinary 
profession. 

In  1824,  five  years  after  Sewell's  introduction,  we  find 
it  practised  on  the  Continent  by  Girard.  We  gather, 
however,  from  the  writings  of  Percival  and  Liautard,  that 
both  in  this  country  and  on  the  Continent  the  operation 
was  for  several  years  largely  in  the  stage  of  experiment. 
Unsuitable  subjects  were  operated  on;  the  work  afterwards 
given  to  the  animal  improperly  adjusted  to  his  altered  con- 
dition; and  the  bad  after-results  of  the  operation  almost 
ignored  by  some,  and  greatly  exaggerated  by  others.  In 
fact,  some  long  time  elapsed  before  veterinary  surgeons 
allotted  to  the  operation  that  measure  of  credit  which  the 
results  following  it  warranted. 

The  Object  of  the  Operation  is  to  render  the  foot  insen- 
sitive to  pain,  and  to  give  to  an  otherwise  incurably  lame 
animal  a  further  period  of  usefulness.  After  the  operation, 
as  time  goes  on,  this  object  may  become  defeated  by  the 
reunion  of  the  divided  ends  of  the  nerve.  In  that  case, 
neurectomy  must  necessarily  be  performed  again. 

The  Operation. — Two  forms  of  neurectomy  are  recog- 
nised— the  high  operation  and  the  low.  The  low  operation 
deals  with  the  posterior  digital  branch  of  the  plantar  nerve, 
and  the  high  operation  with  the  plantar  itself. 

It  is  the  latter  operation  with  which  we  shall  deal  first. 
In  our  opinion  it  is  that  most  likely  to  be  followed  by 
satisfactory  results.  The  area  supplied  by  the  posterior 
digital  is  mainly  the  posterior  portion  of  the  digit     Thus, 


OPERATIONS  ON  THE  FOOT  93 

unless  the  cause  of  the  lameness  is  diagnosed  with  certainty 
to  be  situated  somewhere  in  the  posterior  region  of  the  foot, 
section  of  the  posterior  digital  alone  will  not  give  total 
insensibility  to  pain.  Added  to  that,  we  may  remember 
this :  Below  the  point  at  which  the  digitals  branch  off 
from  the  plantar  there  is  always  more  likelihood  of  the 
part  we  are  attempting  to  render  insensible  being  supplied 
by  another  and  adventitious  branch,  or  a  branch  that,  as 
regards  its  direction,  is  abnormally  distributed.  As  a  last 
consideration,  we  may  say  that  the  higher  operation  is  the 
easier  to  perform. 

Percival,  in  his  works  on  lameness,  has  some  very  sage 
remarks  to  make  by  way  of  a  preliminary,  and  wfe  cannot 
do  better  than  quote  them  here.     He  says : 

'  To  command  success  in  neurectomy  three  considerations 
demand  attention: 

'  1.  The  subject  must  be  fit  and  proper;  in  particular, 
the  diseases  for  which  neurectomy  is  performed  should  be 
suitable  in  kind,  seat,  stage,  etc. 

1  2.  The  operation  must  be  skilfully  and  effectually  per- 
formed. 

'  3.  The  use  that  is  made  of  the  patient  afterwards  should 
not  exceed  what  his  altered  condition  appears  to  have  fitted 
for  him. 

'  The  veterinarian  who  is  guided  by  considerations  such 
as  those  will  find  that  he  has  restored  to  work  horses  who 
would  otherwise  have  been  utterly  useless.  A  plain  and 
safe  argument  wherewith  to  meet  the  objections  to  neurec- 
tomy is  simply  to  ask  the  question  what  the  animal  is  worth, 
or  to  what  useful  purpose  he  can  be  put,  that  happens  to  be 
the  subject  of  such  an  operation. 

'  If  the  horse  can  be  shown  to  be  still  serviceable  and 
valuable,  then  he  is  not  a  legitimate  subject  for  the  opera- 
tion. The  rule  of  procedure  I  have  laid  down  is  to  operate 
on  no  other  but  the  incurably  lame  horse;  and  whenever 
this  has  been  attended  to,  not  only  has  success  been  the 
more  brilliant,  but  idemnification  from  blame  or  reproach 
has  been  assured.' 


94  DISEASES  OF  THE  HORSE'S  FOOT 

Preparation  of  the  Subject. — But  little  in  the  way  of 
medicinal  preparation  is  necessary.  When  the  animal  is  a 
gross,  heavy  feeder,  and  carries  a  more  than  ordinary 
amount  of  cupboard,  all  that  is  needed  is  to  withhold  his 
usual  allowance  of  food  for  some  time  prior  to  the  opera- 
tion, simply  to  avoid  risk  of  rupture  when  casting.  If 
considered  advisable,  a  dose  of  physic  may  also  be  admin- 
istered. 

To  the  seat  of  operation,  however,  careful  attention 
should  be  given.  On  the  day  previous  to  the  operation  the 
hair  should  be  closely  removed  with  the  clipping  machines, 
and  the  skin  thoroughly  cleansed  with  warm  water  and 
soap.  After  this,  a  bandage  soaked  in  a  4  per  cent,  watery 
solution  of  carbolic  acid  should  be  wrapped  lightly  round' 
the  limb,  and  allowed  to  remain  in  position  until  the  animal 
is  cast  and  ready  for  the  operation  the  following  morning. 
On  removing  the  bandage  prior  to  operating,  the  part  should 
again  be  bathed  with  a  cold  5  per  cent,  solution  of  carbolic 
acid  and  swabbed  dry.  Attention  to  these  details  will  serve 
to  leave  the  wound  in  that  favourable  condition  in  which  it 
heals  nicely,  and  with  the  minimum  amount  of  trouble. 

Preliminary  Steps. — By  some  practitioners  the  operation 
is  performed  with  the  animal  standing,  local  anaesthesia 
having  been  first  obtained  by  the  use  of  cocaine,  or  an  ethyl 
chloride  spray.  There  is  no  gainsaying  the  fact,  however, 
that  the  operation  of  neurectomy  is  a  painful  one,  and  that, 
with  most  operators,  success  will  be  more  fully  guaranteed 
with  the  animal  cast  and  the  limb  held  in  a  suitable  position 
by  an  assistant. 

The  animal  is  thrown  by  the  hobbles  upon  the  side  of 
the  leg  which  is  to  be  operated  on.  The  cannon  of  the 
upper  fore-limb  is  then  fixed  to  the  cannon  of  the  upper 
hind,  as  described  under  the  section  of  this  chapter  devoted 
to  the  methods  of  restraint,  and  the  lower  limb  freed  from 
the  hobbles  and  drawn  forward  by  an  assistant  by  means 
of  a  stout  piece  of  cord  round  the  pastern. 

An  alternative  method  of  holding  the  limb  is  to  bind  both 
fore-legs  together  above  the  knee  by  means  of  the  side-line 


OPERATIONS  OX  THE  FOOT 


95 


run  round  a  few  times  in  the  form  of  the  figure  8,  and  then 
fastened  off.  As  in  the  former  method,  the  lower  foot  is 
then  removed  from  the  hobble,  and  again  held  forward  by 


Fig,    57. — The    Esmarch   Rubber   Bandage   and  Tourniquet. 


an   assistant     By   either  method   the  inside   of   the  limb  is 
operated  on  first. 

Although  it  is  not  absolutely  necessary,  it  is  an  advan- 
tage,   especially    to    the    inexperienced    operator,    to    apply 


Fig.   58. — Rubber   Tourniquet   with  Wooden   Block. 

before  operating  an  Esmarch's  bandage  and  tourniquet 
(Fig.  57).  This  expels  the  greater  part  of  the  blood  from 
the  limb,  and  renders  the  operation  comparatively  blood- 
less. 


96 


DISEASES  OF  THE  HORSE'S  FOOT 


The  Esmarch  bandage  is  composed  of  solid  rubber,  and 
with  it  the  limb  is  bandaged  tightly  from  below  upwards. 
On  reaching  the  knee  the  tourniquet  is  stretched  round  the 
limb,  fastened  by  means  of  its  buckle  and  strap,  and  the 
bandage  removed.  Those  who  feel  they  can  dispense  with 
the  bandage  use  the  tourniquet  alone.  For  this  purpose 
the  form  depicted  in  Fig.  58,  and  the  one  in  general  use  at 
the  Royal  Veterinary  College,  is  more  suitable,  on  account 


Fig.  59. — Neurectomy  Bistoury. 

of  its  wooden  block,  which  may  be  placed  so  as  to  press  on 
the  main  artery  of  supply. 

Instruments  Required. — These  should  be  at  hand  in  an 
earthenware  or  enamelled  iron  tray  containing  just  sufficient 
of  a  5  per  cent,  solution  of  carbolic  acid  to  keep  them 
covered.  Those  that  are  necessary  will  be  a  sharp  scalpel, 
or,  if  preferred,  one  of  the  many  forms  of  bistoury  devised 
for  the  purpose  (see  Fig.  59),  a  pair  of  artery  forceps,  a 
needle  ready  threaded  with  silk  or  gut,  one  of  the  patterns 


Fig.  60. — Neurectomy  Needle. 

of  neurectomy  needle  (see  Fig.  60),  and  a  pair  of  blunt- 
pointed  scissors  curved  on  the  flat.  It  is  also  an  advantage, 
v,hen  once  the  incision  through  the  skin  is  made,  to  employ 
one  of  the  forms  of  elastic,  self-adjusting  tenacula  (see  Fig. 
61)  for  keeping  the  edges  of  the  wound  apart  while  search- 
ing for  the  nerve. 

Incision  through  the  Skin. — We  remember  that  the 
plantar  nerve  of  the  inner  side  is  in  close  relation  with  the 
internal  metacarpal  artery,  and  that  both,  in  company  with 


OPERATIONS  OX  THE  FOOT  97 

the  internal  metacarpal  vein  run  down  the  limb  in  close 
proximity  with  the  inner  border  of  the  flexor  tendons.  Also, 
we  remember  that  the  external  plantar  nerve  has  no  atten- 
dant artery,  although,  like  its  fellow,  it  is  to  be  found  in 
close  touch  with  the  edge  of  the  flexor  tendons. 

Bearing  these  landmarks  in  mind,  we  feel  for  the  nerve 
in  the  hollow  just  above  the  fetlock-joint  by  noting  the 
pulsations  of  the  artery,  and  determining  the  edge  of  the 
flexor  tendons.  This  done,  a  clean  incision  is  made  with 
the  bistoury  or  the  scalpel  in  the  direction  of  the  vessel. 
Ihe  incision  should  be  made  firmly  and  decisively,  so  that 
the  skin  may  be  cleanly  penetrated  wTith  one  clear  cut.  If 
judiciously  made,  little  else  in  the  shape  of  dissection  will 
be  needed. 

It  is  nowr  that  the  double  tenaculum  (Fig.  61)  is  applied. 


Fig.  61. — Double  Tenaculum. 

One  clip  is  fixed  to  the  anterior  edge  of  the  wound,  and  the 
other  carried  beneath  the  limb  and  made  to  grasp  the 
posterior  edge.  If  found  desirable  to  keep  the  edges  of  the 
wound  apart,  and  no  tenaculum  to  hand,  the  same  end  may 
be  accomplished  by  means  of  a  needle  and  silk.  In  like 
manner  as  is  the  tenaculum,  the  silk  is  attached  to  one  edge 
of  the  wound,  carried  under  the  limb,  and  firmly  secured  to 
the  other. 

Having  made  the  incision,  the  wound  should  be  wiped 
free  from  blood  by  means  of  a  pledget  of  cotton-wool 
previously  soaked  in  a  carbolic  acid  solution  and  squeezed 
dry.  At  the  bottom  of  the  wound  will  now  be  seen  the 
glistening  white  sheath,  containing  the  vein,  artery,  and 
nerve.  This  should  be  picked  up  with  the  forceps,  and  a 
further  incision  made  with  the  bistoury.  Care  should  be 
exercised  in  making  this  second  incision,  or  the  artery  may 


98  DISEASES  OF  THE  HORSE'S  FOOT 

accidentally  be  opened.  If  an  ordinary  scalpel  is  used,  the 
lower  end  of  the  sheath  should  be  picked  up  and  the  point 
of  the  scalpel  inserted  through  it.  With  the  cutting  edge 
of  the  scalpel  turned  towards  the  opening  of  the  wound., 
the  sheath  is  then  slit  from  below  upwards.  The  second 
incision  satisfactorily  made,  the  wound  is  again  wiped  dry, 
and  the  nerve  seen  as  a  piece  of  white,  curled  string  in  the 
posterior  portion  of  the  wound. 

At  this  stage  i  t  is  advisable  to  accurately  ascertain 
whether  what  we  have  taken  to  be  the  nerve  actually  is  it. 
This  is  done  by  taking  it  up  with  the  forceps  and  giving  it 
a  sharp  tweeze.  A  sudden  struggle  on  the  part  of  the 
patient  will  then  leave  no  doubt  in  the  operator's  mind  that 
it  is  the  nerve  he  has  interfered  with. 

Section  of  the  Nerve. — The  neurectomy  needle  (Fig.  60) 
is  now  taken,  and,  excluding  the  other  structures,  passed 
under  the  nerve.  A  piece  of  stout  silk  or  ordinary  string 
is  then  threaded  through  the  eye  of  the  needle,  the  needle 
withdrawn,  and  the  silk  left  in  position  under  the  nerve. 
The  silk  is  now  tied  in  a  loop,  and  the  nerve  by  this  means 
gently  lifted  from  its  bed.  With  the  curved  scissors  or  the 
scalpel  it  is  severed  as  high  up  as  is  possible.  The  lower 
end  of  the  severed  nerve  is  then  grasped  firmly  with  the 
forceps,  pulled  downwards  as  far  as  possible,  and  then  cut 
off.     At  least  an  inch  of  the  nerve  should  be  excised. 

The  animal  is  then  turned  over,  and  the  opposite  side  of 
the  limb  operated  on  in  the  same  manner. 

The  tourniquet  is  now  removed,  and  the  wound  is  exam- 
ined for  bleeding  vessels.  If  the  haemorrhage  is  only 
slight,  the  wound  should  be  merely  dabbed  gently  with  the 
antiseptic  wool  until  it  has  stayed.  A  larger  vessel  may  be 
taken  up  with  the  artery  forceps  and  ligatured,  or  the 
hemorrhage  stopped  by  torsion.  On  no  account,  unless  it 
is  done  to  stay  haemorrhage  that  is  otherwise  uncontrollable, 
should  the  wound  be  sutured  with  blood  in  it.  With  the 
wound  once  dry  and  clean,  it  is  well  to  insert  three  or  four 
silk  sutures,  but  care  must  be  taken  not  to  draw  them  too 
tightly.     This  done,  the  patient  may  be  allowed  to  get  up. 


OPERATIONS  ON  THE  FOOT  99 

After-treatment. — This  is  simple.  Over  each  wound  is 
placed  a  pledget  of  antiseptic  cotton-wool  or  tow,  and  the 
whole  lightly  covered  with  a  bandage  soaked  in  an  anti- 
septic solution.  For  the  first  night  the  animal  should  be 
tied  up  short  to  the  rack,  and  the  following  morning  the 
bandages  removed.  A  little  boracic  acid  or  iodoform,  or  a 
mixture  of  the  two  combined  with  starch  (  starch  and  boracic 
acid  equal  parts,  iodoform  1  drachm  to  each  ounce)  should 
now  be  dusted  over  the  wounds,  the  antiseptic  pledgets 
renewed,  and  the  bandage  readjusted  over  all. 

At  the  end  of  three  or  four  days  the  bandages  may  be 
dispensed  with.  All  that  is  necessary  now  is  an  occasional 
dusting  with  an  antiseptic  powder,  and,  as  far  as  possible, 
the  restriction  of  movement.  At  the  end  of  a  week  the 
sutures  may  be  removed,  and  the  animal  turned  into  a 
loose  box  or  out  to  pasture. 

E.    MEDIAN  NEURECTOMY. 

As  a  palliative  for  lameness  when  confined  to  the  foot, 
one  would  imagine  that  the  plantar  operation  would  be  all 
sufficient.  There  are  operators,  however,  who  state  that 
the  results  following  section  of  the  median  nerve  have  been 
such  as  to  cause  them  to  entirely  abandon  the  lower  opera- 
tion in  its  favour.  If  only  for  that  reason  a  brief  mention 
of  the  operation  must  be  made  here. 

The  operation  was  first  performed  in  this  country  in 
October,  1895,  the  subject  being  one  of  the  out-patients  at 
the  Royal  Veterinary  College  Free  Clinique. 

For  five  or  six  years  following  this  date  Professor 
Hobday  performed  the  operation  some  several  hundred 
times,  annd  was  certainly  instrumental  in  bringing  the 
operation  into  prominence.  Though  so  recently  introduced 
here,  it  appears  to  have  been  practised  for  several  years  on 
the  Continent,  originating  in  Germany  as  early  as  1867. 
]n  that  country  a  first  public  account  of  it  was  published  in 
1885  by  Professor  Peters  of  Berlin,  while  in  France  it  was 
introduced  by  Pellerin  in  1892. 


100        DISEASES  OF  THE  HORSE'S  FOOT. 

In  this  operation  a  portion  of  the  median  nerve  is  ex- 
cised on  the  inside  of  the  elbow-joint  just  below  the  internal 
condyle  of  the  humerus.  Here  the  nerve  runs  behind  the 
artery,  then  crosses  it,  and  descends  in  a  slightly  forward 
direction  behind  the  ridge  formed  by  the  radius. 

The  position  of  the  limb  most  suitable  for  the  opera- 
tion is  exactly  that  we  have  described  as  most  convenient 
for  the  plantar  excision-  The  animal  is  cast,  preferably 
anaesthetized,  and  the  limb  removed  from  the  hobbles,  and 
heldj  as  far  forward  as  is  possible  by  an  assistant  with  the 
side-line. 

Professor  Hobday's  description  of  the  operation  is  as 
follows : 

'A  bold  incision  is  made  through  the  skin  and  apon- 
eurotic portion  of  the  pectoralis  transversus  and  panniculus 
muscles,  about  1  to  3  inches  (depending  on  the  size  of  the 
horse)  below  the  internal  condyle  of  the  humerus,  and 
immediately  behind  the  ridge  formed  by  the  radius.  This 
latter,  and  the  nerve  which  can  be  felt  passing  over  the 
elbow-joint,  form  the  chief  landmarks.  The  haemorrhage 
which  ensues  is  principally  venous,  and  is  easily  controlled 
by  the  artery  forceps.  In  some  cases  I  have  found  it  of 
advantage  to  put  on  a  tourniquet  below  the  seat  of  opera- 
tion, but  this  is  not  always  advisable,  as  it  distends  the 
radial  artery.  We  now  have  exposed  to  view  the  glistening 
white  fascia  of  the  arm,  which  must  be  incised  cautiously 
for  about  an  inch.  This  will  reveal  the  median  nerve  itself 
situated  upon  the  red  fibres  of  the  flexor  metacarpi  internus 
muscle.  If  not  fortunate  enough  to  have  cut  immediately 
over  the  nerve,  it  can  be  readily  felt  with  the  finger  between 
the  belly  of  the  flexor  muscle  and  the  radius.'  * 

The  nerve  exposed,  the  remainder  of  the  operation  is 
exactly  as  that  described  in  removing  the  portion  of  the 
nerve  in  the  plantar  operation.  The  wound  is  sutured  and 
suitably  dressed,  and  a  fair  amount  of  exercise  afterwards 
allowed  the  patient. 

*  Journal  of  Comparative  Pathology  and  Therapeutics,  vol.  ix., 
p.  181. 


OPERATIONS  ON  THE  FOOT  101 

F.  LENGTH  OF  REST  AFTER  NEURECTOMY. 

This  is  placed  by  the  majority  of  surgeons  at  about 
three  weeks  to  a  month.  Within  that  period  no  excessive 
exertion  should  be  undergone  by  the  patient.  A  certain 
amount  of  quiet  exercise,  however,  is  beneficial,  facilitating 
the  healing  of  the  wounds,  and  accustoming  the  animal 
to  the  altered  condition  of  his  limb. 

G.    SEQUELAE    OF    NEURECTOMY. 

These  we  shall  relate  collectively,  making  no  distinction 
between  those  following  excision  of  the  plantar  nerve  and 
those  succeeding  section  of  the  median.  It  must  be  remem- 
bered by  the  surgeon,  however,  that  the  unfortunate  sequelae 
we  are  now  about  to  describe  are  likely  to  be  far  more  grave 
when  following  section  of  the  larger  nerve. 

Liability  of  Pricked  Foot  going  undetected. — On  account 
of  the  warning  they  convey  to  the  surgeon,  first  place 
among  the  sequelae  of  neurectomy  must  be  given  to  acci- 
dents following  loss  of  sensation.  Take,  for  example, 
punctured  foot.  In  any  case,  in  the  sense  of  being  unfore- 
seen, it  is  accidental.  In  the  neurectomized  foot  it  becomes 
doubly  accidental,  in  that  not  only  is  it  unforeseen,  but  that 
it  is  for  some  time  indiscoverable.  With  the  foot  deprived 
of  sensation,  a  nail  may  be  picked  up,  or  a  prick  sustained 
at  the  forge,  and  no  intimation  given  to  the  attendant  until 
pus  has  underrun  the  horn,  and  broken  out  at  the  coronet. 
What  follows,  then,  is  that  the  hoof  as  a  whole,  or  the 
greater  part  of  it,  sloughs  off. 

No  neurectomy  should  be  undertaken  unless  this  con- 
tingency has  been  allowed  for.  The  owner  should  be 
advised  of  it  by  the  surgeon,  who  should  at  the  same  time 
enjoin  on  his  client  absolute  necessity  of  giving  to  the 
neurectomized  foot  daily  and  careful  attention. 

Loss  of  Tone  in  the  Non-sensitive  Area. — In  addition  to 
the  mischief  resulting  from  a  wound  going  undetected,  it 
must  be  remembered  that  the  loss  of  tone  resulting  from 
the  operation  gives  to  every  wound    (however  slight,)   in 


102         DISEASES  OF  THE  HORSE'S  FOOT 

the  region  supplied  by  the  removed  nerve,  a  sluggish  and 
troublesome  character.  Difficult  to  deal  with  as  wounds 
about  the  foot  ordinarily  are,  they  are  rendered  more  so  by 
a  previous  neurectomy. 

Gelatinous  Degeneration. — This  is  a  condition  liable  to 
occur  in  cases  where  the  operation  has  been  too  long 
deferred,  and  when  considerable  structural  alteration  has 
already  taken  place  in  the  shape  of  diseased  bone  or 
tendon,  more  especially  in  navicular  disease.  It  consists 
in  a  peculiar  softening  of  the  structures  of  the  limb, 
accompanied  with  enlargement,  due  to  swelling  of  the 
connective  tissues,  the  enlargement  and  softening  gener- 
ally making  itself  first  apparent  by  a  soft,  pulpy  swelling 
in  the  hollow  of  the  heel. 

From  this  onwards  the  enlargement  increases,  and  lame- 
ness becomes  excessive,  the  animal  going  more  and  more 
on  his  heels,  until,  finally,  no  portion  of  the  solar  surface 
of  the  foot  comes  to  the  ground  at  all. 

The  case  is  hopeless,  and  destruction  should  be  advised. 

Reported  Case. — '  The  patient,  a  brown  carriage  gelding, 
was  brought  to  the  Royal  Veterinary  College  infirmary  in  a 
cart  on  December  31,  the  only  previous  history  obtainable 
being  that  it  had  suddenly  fallen  lame  a  month  before. 

'  The  symptoms  presented  were  excessive  lameness  of  the 
near  fore-limb.  On  being  trotted,  the  toe  was  elevated  each 
time  the  foot  reached  the  ground,  progression  being  entirely 
on  the  heels.  Separation  of  the  hoof  for  about  2  inches  at 
the  hinder  part  of  the  coronet;  cedematous  swelling  from 
foot  to  knee,  extending  during  the  next  three  days  to  the 
elbow.  Great  tenderness  between  the  knee  and  the  fetlock ; 
below  this  no  sensation  whatever,  as  a  pin  was  inserted  in 
several  places  round  the  coronet  without  causing  any  symp- 
toms of  pain.  On  further  examination,  two  unnerving  scars 
were  found.  No  treatment  was  adopted,  and  the  horse  was 
destroyed  on  January  6. 

'  On  dissecting  the  leg,  the  following  appearances  pre- 
sented themselves : 

'  The  limb  was  very  much  enlarged,  due  to  thickeninng  of 


OPERATIONS  ON  THE  FOOT  103 

the  connective  tissue,  the  skin  being  removed  only  with 
difficulty.  The  tendons  were  soft  and  much  thickened.  A 
rupture  of  the  skin  at  the  coronet,  just  where  the  skin 
meets  the  wall  of  the  foot.  Large  extravasations  of  blood 
at  the  back  of  the  tendons,  situated  in  the  lower  half. 
External  nerve  trunk  had  become  reunited,  at  the  point 
of  junction  there  being  a  hard  lump  about  the  size  of  a 
walnut.  Internal  nerve  trunk  also  had  become  reunited, 
and  presented  a  thickened  portion  at  the  point  of  junction, 
but  not  so  large  as  that  of  the  outer  side,  and  situated  in 
the  lower  half  of  the  tendon,  about  2  inches  higher  than 
that  on  the  external  nerve.  This  nerve  trunk  was  atro- 
phied below  the  thickening,  and  had  undergone  gelatinous 
degeneration.  Judging  from  the  scars  on  the  skin,  this 
side  had  evidently  been  unnerved  a  week  or  ten  days  pre- 
viously to  that  on  the  outer  side.  The  band  stretching 
across  the  back  of  the  perforatus,  between  the  external  and 
internal  nerves,  appeared  on  the  inside  to  have  become 
firmly  fixed  into  the  tendon. 

'  On  removing  the  hoof,  under  the  sole  there  appeared  a 
large  quantity  of  very  foetid  pus ;  the  laminae  were  very 
much  inflamed  in  patches.  There  was  an  enormous  thick- 
ening of  connective  tissues  in  the  heel.  On  cutting  longi- 
tudinally through  the  perforatus  tendon,  there  was  exposed 
a  large  blood-coloured  mass,  of  a  gelatinous  appearance, 
situated  on  the  perforatus  tendon,  the  latter  being  very 
much  thickened,  and  growing  to  the  navicular  bone.  The 
underneath  surface  of  the  superior  suspensory  ligament 
was  much  thickened,  and  firmly  adherent  to  the  bone ;  at 
the  posterior  surface  of  the  metacarpus  there  was  a  quan- 
tity of  gelatinous  substance.  The  anterior  ligament  of  the 
fetlock-joint  was  thickened;  the  navicular  bone  was  entire, 
but  showed  lesions  of  navicular  disease,  being  ulcerated. 
Section  through  the  bone  did  not  reveal  anything  further.  It 
may  be  here  remarked  that  the  ulcerations  were  on  either 
side  of  the  central  ridge,  and  not  at  all  on  the  ridge  itself. 

1  Microscopic  examination  of  the  tissue  joining  the  two 
ends  of  the  nerve  together  revealed  a  few  nerve  fibres  :  the 


104         DISEASES  OF  THE  HORSE'S  FOOT 

general  appearance  was  that  of  granulation  tissue,  contain- 
ing capillary  vessels,  which  were  fairly  plentiful,  and  com- 
paratively large  in  size.'  * 

Chronic  (Edema  of  the  Leg. — In  some  cases  there  is  a 
distinct  swelling  of  the  leg  some  time  after  the  operation. 
This  exposes  the  limb  to  the  infliction  of  sores  from  striking 
with  the  opposite  foot,  with,  of  course,  the  difficulty  in 
healing  we  have  just  described. 

Persistent  Pruritus. — This  annoying  sequel  occurs  in  the 
neurectomized  limb,  with  or  without  gelatinous  degenera- 
tion, and  appears  to  be  without  a  remedy.  The  itching  in 
some  cases  is  so  intense  as  to  lead  the  animal  to  constantly 
gnaw  at  the  top  of  the  foot.  As  one  observer  has  remarked, 
the  animal  may  begin  literally  biting  pieces  out  of  his  limb. 
The  result  of  the  irritation  and  gnawing  is  fatal.  Great 
sloughing  of  the  parts  takes  place,  and  the  animal  has 
eventually  to  be  slaughtered. 

Fracture  of  the  Bones. — The  sudden  loss  of  sensation  in  a 
foot  may  cause  the  animal  to  use  violently  the  limb  he  has 
for  months  past  been  carefully  nursing.  It  may  be  that 
the  lameness  for  which  the  operation  has  been  performed 
has  been  due  to  disease  existing  in  the  navicular  bone,  and 
extending,  perhaps,  to  the  os  pedis.  By  the  disease  the 
bone  has  already  been  made  brittle,  its  substance  and 
ligamentous  attachments  perchance  weakened  and  broken 
up  by  a  slow-spreading  caries,  and  rarefaction  of  the 
remaining  bone  substance  rendered  almost  certain.  In  this 
instance,  the  free  use  of  the  foot,  and  the  application  to 
the  diseased  structures  of  an  unwonted  pressure  immedi- 
ately after  the  operation  results  in  fracture.  With  the  rupture 
of  the  structures  we  get  the  elevated  toe  and  soft  swelling 
in  the  heel,  as  described  in  gelatinous  degeneration. 
Treatment,  of  course,  is  out  of  the  question. 

Neuroma.  A  further  sequel  is  the  appearance  at  the  seat 
of  the  operation  of  what  is  termed  an  '  amputational 
neuroma.'  This  is  a  tumour-like  growth  occurring  on  the 
end  of  the  divided  nerve.     It  is  composed  of  connective- 

*  Veterinary  Record,  vol.  iv.,  p.  386  (Hobday). 


OPERATIONS  OX  THE  FOOT  105 

tissue  elements  permeated  by  nerve  fibres  which  have 
grown  out  from  the  axis-cylinders  of  the  nerve  stump. 
It  may  vary  in  size  from  a  pea  to  a  hazel-nut,  and  is 
frequently  the  cause  of  much  pain.  This  must  be  cut  down 
upon  and  cleanly  removed,  taking  away  at  the  same  time 
as  much  of  the  nerve  as  is  possible. 

Reunion  of  the  Divided  Nerve. — We  may  say  at  once  that 
'  reunion  '  in  the  popular  sense  of  the  word  does  not  take 
place.  At  a  varying  period  after  section,  however,  we  do 
get  a  return  of  sensation.  This  is  brought  about  in  the 
following  manner :  The  axis-cylinder  of  the  nerve,  still  in 
connection  with  the  spinal  cord,  swells  somewhat,  and 
hypertrophies.  The  cells  of  this  hypertrophied  portion 
show  a  great  tendency  to  proliferate  and  produce  new  nerve 
structure.  This  growing  point  splits,  and  gives  rise  to 
several  fibrils,  which  are  new  axis-cylinders.  These  com- 
mence to  grow  towards  the  periphery,  and,  in  so  doing, 
grow  through  the  cicatricial  tissue  that  has  formed  at  the 
seat  of  the  operation. 

After  passing  through  the  cicatricial  tissue  (the  amount 
cf  which  tissue,  of  course,  controls  the  length  of  time  that 
insensibility  remains  ),  the  growing  axis-cylinders  reach  the 
degenerated  portions  of  the  nerve  below  the  point  of  section. 
It  is  along  the  track  of  the  old  nerve  that  the  new  growths 
from  the  stump  reproduce  themselves. 

The  fact  of  the  new  growths  having  to  pass  through  the 
fibrous  tissue  of  the  cicatrix  before  they  can  gain  the  course 
of  the  old  nerve,  along  which  latter  their  progress  of  growth 
is  comparatively  easy,  affords  ample  illustration  that  as 
large  a  portion  as  is  possible  of  the  nerve  should  be  removed 
when  operating,  in  order  to  convey  insensibility  for  the 
longest  time.  After  reunion,  of  course,  nothing  remains 
but  to  repeat  the  operation. 

The  Existence  of  an  Adventitious  Nerve-supply. — While 
not  exactly  a  sequel  of  the  operation,  the  fact  that  it  is  not 
discovered  until  after  the  operation  has  been  performed 
warrants  us  in  mentioning  it  here.  It  is  not  an  uncommon, 
thing   in   the   lower    operation   to   find   that   sensation   and 


106         DISEASES  OF  THE  HORSE'S  FOOT 

symptoms  of  lameness  still  persist  after  section  of  the  nerve. 
In  many  cases  this  has  been  traced  to  the  existence  of  an 
abnormal  nerve  branch.  In  the  higher  operation  this  is 
not  so  likely  to  be  met  with.  That  it  may  occur,  however, 
is  shown  by  the  following  interesting  case  related  by  Harold 
Sessions,  F.R.CV.S. :  * 

1  In  June  of  1898  I  saw  a  hunter  suffering  from  navicular 
disease.  After  carefully  examining  the  leg,  I  advised  the 
owner  to  have  the  operation  of  neurectomy  performed  upon 
him.  This  he  decided  to  do,  and  the  horse  was  sent  to  me 
about  the  beginning  of  July. 


Fig.   62. — Dissected   External   Metacarpal   Nerve  and  Branches. 

a,  Metacarpal;  b,  anterior  plantar;  c,  extra  branch  (probably  from 
the  internal  metacarpal),  conveying  sensation  after  division  of 
the  external  metacarpal. 

'  The  operation  was  performed  in  the  ordinary  way,  with- 
out any  difficulty  whatever.  The  wounds  healed  nicely, 
but  the  horse  still  continued  to  go  lame.  Careful  examina- 
tion showed  that  there  was  still  sensation  on  the  outside  of 
the  foot.  Thinking  that  possibly  there  might  be  two 
external  metacarpal  nerves,  the  horse  was  again  cast,  the 
operation  being  performed  slightly  lower  down.  Only  the 
main  branch  of  the  external  metacarpal  nerve  could  be 
found.  A  piece  of  this  was  taken  out,  and  the  horse  let  up. 
On  examination,  sensation  was  still  found  in  the  posterior 
part  of  the  outside  of  the  foot.  It  was  very  evident  that 
there  was  some  abnormal  distribution  of  the  nerve,  as 
sensation  was  still  being  conveyed  to  that  part  of  the  foot. 

'  As  the  horse  was  absolutely  useless,  and  would  have  to 

*  Journal  of  Comparative  Pathology  and  Therapeutics,  vol.  xii , 
P-  343- 


OPERATIONS  OX  THE  FOOT  107 

be  shot  unless  this  piece  of  nerve  could  be  found,  he  was 
again  thrown,  and  after  he  had  been  anaesthetized  I  deter- 
mined to  follow  the  course  of  the  nerve  down,  until  I  found 
where  the  accessory  branch  came  from.  This  I  found  a 
little  below  the  fetlock,  about  ]/2  inch  below  the  point  where 
the  anterior  plantar  nerve  is  given  off  from  the  metacarpal 
nerve.  It  was  about  l/2  inch  below  the  spot  where  the 
anterior  plantar  nerve  passes  between  the  artery  and  vein 
of  the  foot,  and  it  was  somewhat  difficult  to  get  at  it. 

'  Fig.  62  shows  the  exact  size  and  distribution  of  the 
nerves.  After  the  separation  of  the  accessory  branch, 
sensation  was  taken  from  the  foot,  and  the  horse  went 
perfectly  sound/ 

Stumbling. — In  addition  to  the  sequelae  we  have  men- 
tioned, it  is  urged  against  the  operation  of  neurectomy  that 
one  of  the  first  effects  of  depriving  the  foot  of  the  sense  of 
touch  is  a  tendency  on  the  part  of  the  animal  to  stumble. 
From  the  cases  we  have  seen  we  cannot  regard  this  objection 
as  a  serious  one.  Nevertheless,  as  veterinarians,  with  a 
knowledge  of  the  physiology  of  the  structures  with  which 
we  are  dealing,  we  must  treat  the  objection  with  respect,  for, 
after  all,  we  are  bound  to  allow  that  stumbling,  and  a  bad 
form  of  it,  would  be  but  a  natural  sequence  of  the  operation 
we  have  just  performed.  The  real  fact  remains,  however, 
that  cases  of  stumbling,  even  immediately  after  the  opera- 
tion, are  rare ;  and  that  even  when  they  do  occur,  the  animal 
seems  easily  able  to  accommodate  himself  to  the  altered 
condition,  and  as  readily  uses  the  comparatively  inert  mass 
at  the  end  of  his  limb  as  he  did  previously  the  intact  foot. 

H.    ADVANTAGES  OF  THE   OPERATION. 

From  the  prominence  we  have  given  to  the  unfortunate 
sequelae  of  the  operation  it  might  possibly  be  inferred  that, 
while  not  giving  it  our  absolute  condemnation,  we  regard 
neurectomy  with  a  certain  amount  of  distrust.  That  we 
may  contradict  any  such  false  impression,  we  state  here 
that  in  many  cases  the  operation  is  the  only  measure  which 


108         DISEASES  OF  THE  HORSE'S  FOOT 

will  offer  relief  from  pain,  and  restore  to  work  an  otherwise 
useless  animal.  In  support  of  that  we  will  now  quote  the 
recognised  advantages  of  the  operation. 

That  in  many  cases,  when  all  other  methods — surgical 
and  medicinal — have  failed,  there  is  an  immediate  and 
total  freedom  from  pain  and  lameness  no  one  will  deny. 
This,  if  it  restores  to  active  work  an  animal  that  would 
otherwise  have  had  to  have  been  cast  aside,  is  ample 
justification  for  giving  the  operation,  in  spite  of  its  many 
unfortunate  terminations,  a  real  place  among  the  more 
highly  favoured  remedial  measures  to  our  hand. 

'  For  Contracted  Hoofs,  viewing  them  in  the  light  of 
idiopathic  disease,  or  as  being  the  immediate  cause  of  the 
existing  lameness  in  the  uninflamed  condition  of  the  foot, 
and  when  consequential  changes  of  its  organism  have  taken 
place  which  bid  defiance  to  therapeutic  measures,  neurotomy 
is  a  warrantable  resource'  (Percival). 

For  Ringbone  neurotomy  has  been  practised  with 
perfect  success,  after  blistering  and  firing  had  both  failed, 
notwithstanding  the  work  the  animal  had  to  perform 
afterwards  was  of  the  most  trying  nature'   (ibid.). 

For  Navicular  Disease,  when  that  malady  is  diagnosed, 
the  earlier  neurectomy  is  performed  the  better  The 
greater  work  given  to  the  diseased  bursa  and  bone,  and 
the  return  of  the  contracted  heels  to  the  normal,  brought 
about  by  the  greater  freedom  with  which  the  foot  is  used, 
are  claimed  by  many  to  effect  a  cure. 

Writing  of  navicular  disease,  and  mentioning  his  belief 
in  the  possibility  of  the  diseased  bone  effecting  its  own 
repair  after  the  operation,  Harold  Leeney,  M.R.C.V.S., 
says: 

'  The  expansion  of  the  heel,  and  rapid  development  of 
the  frog  (in  this  and  many  other  cases)  immediately  after 
the  operation,  has  not,  I  venture  to  think,  attracted  so 
much  attention  as  it  deserves,  and  many  have  something 
to  do  with  those  cases  which  appear  to  be  actually  cured, 
not  merely  made  to  go  sound  by  absence  of  pain.'  * 
*  Veterinary  Record,  vol.  xi.,  p.  297. 


OPERATIONS  ON  THE  FOOT  109 

Speaking  of  the  median  operation  before  a  meeting  of 
the  Central  Veterinary  Medical  Society,  Professor  Hobday 
bays  :* 

'  For  old-standing  lameness,  when  due  to  splints, 
exostoses,  chronically  sprained,  thickened,  and  painful 
perforans  and  perforatus  tendons,  or  cases  of  that  kind 
which  cause  pain  by  pressing  on  the  adjacent  nerve 
structures,  after  all  other  known  methods  have  failed, 
median  neurectomy  is  the  operation  which  will  be  most 
likely  to  give  the  animal  a  new  lease  of  life  and  useful- 
ness.' 

'  Of  the  Humanity  and  Utility  of  Neurectomy  there  can 
be  no  question  whatever,  and  provided  the  cases  are  well 
selected,  and  the  operation  is  efficiently  performed,  the 
advantages  to  be  derived  from  it  are  most  striking  as  well 
as  enduring.  But  the  disadvantages  attending  the  loss  of 
sensation  in  the  foot  have  been  brought  forward  on  many 
occasions  as  an  argument  against  neurectomy,  and  no  one 
can  deny  that  the  foot  with  sensation  is  better  than  one 
without  that  faculty.  But  in  a  long  experience  of  the 
operation  I  have  never  found  these  disadvantages  outweigh 
the  great  advantages  which  have  immediately  followed  it.' 

Beyond  these,  the  direct  advantages  of  neurectomy,  are 
ether  and  more  indirect  advantages  which  claim  attention. 

The  most  astonishing  among  them  is  the  fact  noted  by 
many  writers  of  repute  that  exostoses  (ringbones,  side- 
bones,  splints,  etc.)  rapidly  diminish  in  size.  This  is 
vouched  for  by  such  well-known  authorities  as  Zundel  and 
Nocard. 

Percival,  too,  mentions  at  some  length  the  effect  of  the 
removal  of  pain  on  the  cestral  and  generative  functions, 
quoting  the  case  of  a  brood  cart-mare  by  reason  of  bony 
deposits  being  stayed  from  breeding  for  some  years.  Two 
months  after  the  operation  she  went  to  work,  and  moved 
sound,  her  altered  condition  leading  her  to  breed  several 
healthy  foals. 

*  Veterinary  Record,  vol.  xiii.,  p.  427. 

t  Veterinary  Journal,  vol.  ix.,   p.   178    (Fleming). 


110         DISEASES  OF  THE  HORSE'S  FOOT 

I.    THE  USE  OF  THE  HOESE  THAT  HAS  UNDERGONE 
NEURECTOMY. 

No  operation  is  of  any  considerable  value  to  the  veterinary 
surgeon  unless  he  is  able  to  show  that  after  it  he  has  left 
his  patient  workable.  The  alleviation  of  pain  alone,  com- 
mendable as  it  is  from  a  humanitarian  standpoint,  is  of  no 
interest  to  the  average  owner  of  horse-flesh,  unless  with  it 
he  sees  his  animal  capable  of  justifying  his  existence  by 
the  amount  of  labour  performed. 

Criticised  in  this  way,  is  the  operation  of  neurectomy 
justifiable?  Upon  that  point  the  opinions  of  many  prac- 
titioners, even  at  the  present  day,  differ.  We  have  already 
partly  answered  the  objections  likely  to  be  raised  on  this 
score  by  stating  that  the  work  afterwards  allotted  the 
animal  should  be  fixed  to  suit  his  altered  condition.  It 
may  be  taken  as  a  general  rule  that  in  all  cases  where  the 
animal's  usefulness  depends  upon  his  delicacy  of  touch,  as, 
for  example,  animals  used  solely  for  hacking  or  hunting, 
his  future  usefulness  in  that  special  sphere  of  work  will  be 
done  away  with. 

Percival  himself,  always  a  strong  advocate  for  the 
operation,  fully  recognises  this.  '  Does  the  neurotomized 
horse  maintain  the  same  step  as  before?'  he  asks.  'To 
this  important  question,'  he  replies,  '  I  unhesitatingly 
answer  no ;  he  does  not.  There  can  be  no  doubt  but  that 
the  horse  feels  the  ground  upon  which  he  is  treading,  and 
that  he  regulates  his  action  in  consonance  with  such  feeling, 
so  as  to  render  his  step  the  least  jarring  and  fatiguing  to 
himself,  and  therefore  the  easiest  and  pleasantest  to  his 
rider.  .  .  .  Such  impressions  ' — those  of  touch — '  being 
in  the  neurotomized  subject,  so  far  as  regards  the  feeling 
(.  f  the  foot,  altogether  wanting,  a  bold,  fearless  projection 
of  the  limb  in  action  will  be  the  consequence,  followed  by  a 
putting  down  of  the  hoof  flat  upon  the  ground,  as  though 
it  were  a  block,  creating  a  sensation  alike  unpleasant  both 
to  horse  and  rider.' 

Emphatic    as    Percival    is    upon    this    point,    there    are, 


OPERATIONS  OX  THE  FOOT  111 

nevertheless,  others  who  maintain  with  equal  stoutness  that 
the  unnerved  animal  is  positively  as  safe,  if  not  safer,  than 
the  animal  who  has  not  been  so  treated. 

'  That  the  tactile  sense  in  the  horse's  foot  is  useful,  it 
would  be  idle  to  deny ;  but  that  it  is  absolutely  essential, 
even  to  safe  progression,  no  one  who  has  paid  attention  'to 
the  results  of  plantar  neurectomy  will  maintain.  On 
several  occasions  for  years  I  have  hunted,  hacked,  and 
driven  horses  which  have  been  deprived  of  sensation  in 
their  fore-feet,  and  never  had  an  accident  with  them. 
Their  action  has  not  been  impaired  by  the  operation ;  on 
the  contrary,  it  has  been  vastly  improved  compared  with 
what  it  had  been  previous  to  it.  And  my  opinion  has  not 
been  single  in  this  respect,  as  many  competent  horsemen 
can  give  like  evidence  after  long  and  severe  trials  of 
neurotomized  horses.  The  opponents  of  neurectomy  were, 
probably,  not  aware  that  there  is  in  progression  a  muscular 
as  well  as  a  tactile  sense.' 

This  latter  contention  is  supported  by  numerous  cases, 
reported  at  the  time  when  the  operation  of  neurectomy  was 
at  the  heyday  of  its  popularity.  Two  I  select  from  writings 
of  a  later  period: 

Recorded  Cases. — 1.  '  Two  of  the  finest  among  the  many 
line  horses  in  the  Second  Life  Guards  were  so  lame  from 
navicular  disease,  when  I  joined  the  regiment,  that  they 
were  unsafe  and  unsightly  to  ride,  and  were  therefore 
entered  on  the  list  to  be  cast  off  and  sold.  One  was  so 
crippled  that  it  could  scarcely  be  moved  out  of  its  stable. 
Feeling  sorry  at  having  to  get  rid  of  such  good  horses,  and 
anxious  to  give  another  blow  to  the  mistaken  theory  that 
unnerved  animals  were  unsafe,  I  obtained  the  consent  of  my 
commanding  officer,  who  patronizes  practical  conclusions, 
to  perform  neurotomy.  This  was  carried  out  on  both  horses 
about  eighteen  months  ago.  Within  a  fortnight  they  were 
at  their  duty,  absolutely  free  from  lameness,  and  with  first- 
rate  action,  and  one  of  them,  from  being  troublesome  and 
unsteady  in  the  ranks — probably  from  the  pain  in  its  feet — 
had  become  quite  steady  and  tractable.     Instead  of  being 


112         DISEASES  OF  THE  HORSE'S  FOOT 

bme,  blundering,  and  unsafe,  both  were  sound,  free  in 
movement,  and  secure,  and,  the  pain  being  abolished,  they 
looked  improved  in  condition. 

'  During  the  month  of  July  the  regiment  attended  the 
summer  drills  at  Aldershot,  and  five  days  every  week  for  a 
month  these  horses  carried  a  weight  of  about  22  stones 
each  over  the  roughest  and  most  dangerous  ground,  nearly 
always  at  a  fast  pace,  and  for  four,  five,  or  six  hours  each 
day ;  and  yet  they  never  fell  or  blundered,  and  the  troopers 
who  rode  them  had  unbounded  confidence  in  their  sure- 
footedness.  They  returned  to  Windsor,  at  the  end  of  the 
month's  severe  test,  as  sound  in  their  paces  as  when  they 
left,  and  certainly  now  offer  no  indication  whatever  that 
they  are  less  safe  to  ride  than  any  other  horse  in  the  regi- 
ment. The  effects  of  the  relief  from  pain  are  also  most 
marked,  not  only  in  the  altered  gait  out  of  doors,  but  also 
in  the  stable'* 

2.  '  Some  years  ago  I  operated  upon  a  valuable  hunter, 
the  property  of  a  gentleman  in  Kildare,  the  animal  having 
shown  unmistakable  symptoms  of  navicular  disease  for 
some  months  previously,  and  which  had  been  unsuccess- 
fully combated  by  the  milder  forms  of  treatment  for  the 
disease  without  any  benefit.  Although  the  horse  went 
sound,  the  owner  feared  to  ride  him,  and  sent  him  to  be 
sold  in  Dublin,  where  he  was  disposed  of  for  a  small  price, 
and  I  then  lost  sight  of  him.  The  following  Punchestown 
Races,  to  my  surprise,  amongst  a  group  of  horses  walking 
round  the  paddock  previous  to  saddling  for  an  important 
race,  I  recognised  my  old  patient,  bandaged,  clothed,  and 
trained,  ready  to  take  his  part  in  the  cross-country  contest, 
and  surrounded  by  a  host  of  admirers  willing  to  back  him 
at  any  price. 

'  Having  satisfied  myself  that  it  was  no  other  than  the 
same  animal,  my  first  impulse  was  at  once  to  find  out  the 
jockey  who  was  to  ride  him,  and  warn  him  of  his  danger 
by  telling  him  his  mount  was  devoid  of  feeling  in  both  fore- 
feet; but  the  saddling-bell  had  already  rung,  and  in  a  few 
*  Veterinary  Journal,  vol.  ix.,  p.  178  (George  Fleming,  F.R.C.V.S.). 


OPERATIONS  OX  THE  FOOT  113 

moments  more  the  jockey  emerged  from  the  weighing-room 
and  the  next  view  of  the  horse  was  his  tearing  up  the  course 
in  the  preliminary,  and  "  pulling  double."  I  was  sorry  for 
the  jockey  if  he  felt  as  I  did  at  that  moment,  for  if  he  did 
1  fear  he  and  his  horse  would  have  parted  company  at  the 
first  fence,  as  1  was  certain  there  would  be  a  smash  before 
the  end  of  the  long  and  difficult  three  miles  of  the  Kildare 
Hunt  Cup  course.  It  was  not  until  I  saw  him  again  in  the 
front  rank  passing  the  stand,  in  the  first  round,  that  I 
breathed  freely,  and  even  then  I  felt  very  guilty,  and,  had 
he  come  to  grief  badly,  I  don't  think  I  should  ever  have 
operated  on  another  horse  except  in  such  a  way  as  would 
have  left  unmistakable  traces  after  it. 

'  "  The  old  horse  wins !"  screamed  a  thousand  voices  as 
the  competitors  safely  cleared  the  last  bank  (now  taken 
away  for  a  gorse  fence)  the  last  time  round,  and  from 
that  moment  the  operation  went  up  in  my  estimation  a 
hundredfold,  and  I  almost  lost  all  interest  in  the  finish 
(and  it  was  a  close  one,  with  my  patient  a  good  third), 
resolving  I  would  operate  for  the  future  on  every  animal, 
young  and  old,  which  showed  symptoms  of  navicular 
disease. 

'  Neither  owner  nor  jockey  knew  the  horse  had  been 
operated  on,  and  he  was  soon  after,  on  the  strength  of  his 
performance,  sold  for  a  good  price  to  come  to  England.  It 
is  idle  to  think  that  all  cases  are  as  successful  as  this  was, 
as  experience  soon  told  me ;  but  I  consider  that,  in  careful 
hands,  the  advantages  well  outweigh  the  disadvantages  of 
the  operation,  and  I  have  selected  this  instance  merely  as 
a  practical  example/* 

It  is  solely  with  the  object  of  ventilating  both  sides  of 
the  question  that  we  quote  the  last  two  cases.  In  our 
opinion,  the  colours  in  which  the  results  of  the  operation 
are  there  painted  are  far  too  rosy.  The  practitioner  who  has 
before  him  the  task  of  satisfying  a  client  as  to  what  will  or 
v.  hat  will  not  be  the  results  of  an  operation  he  has  suggested 
will  do  well  to  weigh  each  side  of  the  argument  carefully, 
*  Veterinary  Journal,  vol.  iii.,  p.  254  (W.  Pallin,  M.R.C.V.S.). 


114         DISEASES  OF  THE  HORSE'S  FOOT 

and    endeavour    in    his    explanation    to    strike    the    happy 
mean. 

We  hold,  further,  that  the  animal  who  has  previously 
been  accustomed  to  fast  work,  and  to  work  entailing  a  large 
call  upon  the  sense  of  touch  when  passing  over  rough  and 
uneven  ground,  will  be  far  more  likely,  in  his  neurectomized 
condition,  to  give  satisfaction  to  his  owner  if  put  to  a  slower 
and  a  more  suitable  means  of  earning  his  living. 


CHAPTER  VI. 

FAULTY  CONFORMATION 

Under  this  heading  we  shall  deal  with  such  formations  of 
the  feet  as  depart  sufficiently  from  the  normal  to  render 
them  serious.  Faulty  conformation  may  be  either  con- 
genital or  acquired,  and  acquired  gradually  as  the  result 
of  slowly  operating  causes,  or  suddenly  as  the  sequel  to 
previous  acute  disease.  Whether  congenital  or  acquired, 
serious  in  its  nature  or  comparatively  of  no  account,  the 
veterinary  surgeon  will  often  find  that  the  matter  of  con- 
formation is  one  which  will  have  a  direct  bearing  on  many 
of  his  '  foot  '  cases,  and,  furthermore,  that  it  is  one  upon 
which  he  will  often  be  called  to  give  advice. 

A.   WEAK  HEELS. 

Definition — That  condition  of  the  wall  in  which,  owing 
to  the  softness  of  the  horn  and  the  oblique  direction  of  the 
horn  fibres,  the  heels  are  unable  properly  to  bear  the  body- 
weight,  and,  as  a  consequence,  curve  in  beneath  the  sole. 
We  give  the  condition  first  mention,  not  because  of  its 
greater  importance,  but  for  the  reason  that  it  is  frequently 
the  forerunner  of  the  conditon  to  be  next  described — 
namely,  contracted  feet. 

Symptoms. — The  extreme  point  of  the  heel  is  not  affected 
unless  the  foot  has  been  greatly  neglected,  and  the  con- 
dition allowed  to  develop.  Where,  however,  the  foot  has 
b<>en  uncared  for,  curving  in  of  the  wall  takes  place  to  an 
alarming  degree,   and   the  heels   curl  underneath   the   foot 

115 


116         DISEASES  OF  THE  HORSE'S  FOOT 

to  such  an  extent  as  to  grow  over  the  sole  and  the  bars. 
By  the  pressure  they  exert  on  the  sole  corns  result,  and  the 
animal  is  lamed. 

Causes. — In  the  main  this  defect  is  hereditary  It  is 
seen  commonly  in  connection  with  flat-foot,  and  where  the 
horn  of  the  wall  is  thin  and  shelly. 

Treatment. — In  the  case  of  weak  or  '  turned  in'  heels 
no  suitable  bearing  is  offered  for  the  shoe  in  the  posterior 
half  of  the  foot.  Any  attempt  to  induce  the  heels  to  bear 
weight  is  immediately  followed  by  their  bending  in.  It 
follows  from  this  that  the  best  shoe  to  be  used  here  is  one 
in  which  the  bearing  is  confined  to  the  anterior  half  of 
the  wall,  the  heels  being  relieved  by  being  sufficiently  pared. 
As  might  be  expected,  this  bearing  on  the  anterior  half 
only  of  the  foot  is  insufficient;  pressure  must  be  given  the 
frog.  This  latter  end  is  best  gained  by  a  bar  shoe  (Fig. 
68)-  With  it  the  anterior  portions  of  the  wall,  the  whole  of 
the  bars,  and  the  whole  of  the  frog  may  be  in  contact,  and 
the  heels  only  so  pared  as  to  take  no  bearing  at  all.  A  few 
such  shoeings  sees  the  defect  remedied.  In  every  instance 
paring  of  the  sole  should  be  discouraged,  as  it  serves  but  to 
increase  the  deformity. 

B.    CONTRACTED  FOOT. 
(a)  General  Contraction — Contracted  Heels. 

Definition. — By  the  term  contracted  foot,  otherwise 
known  as  hoof-bound,  is  indicated  a  condition  in  which  the 
foot,  more  especially  the  posterior  half  of  it,  is,  or  becomes, 
narrower  from  side  to  side  than  is  normal. 

It  must  be  borne  in  mind,  however,  that  certain  breeds 
of  horses  have  normally  a  foot  which  nearer  approaches 
the  oval  than  the  circular  in  form,  and  that  a  narrow  foot 
is  not  necessarily  a  contracted  foot. 

The  contraction  may  be  bilateral  when  affecting  both 
heels  of  the  same  foot  and  extending  to  the  quarters,  or 
unilateral  when  the  inside  or  outside  heel  only  is  affected. 

In  some  cases  contraction  is  confined  to  one  foot,  while 


FAULTY  CONFORMATION  117 

in  others  it  may  be  noticed  equally  bad  in  both.  It  is  a 
matter  of  common  knowledge  that  contraction  is  usually 
seen  in  the  fore-feet,  while  the  hind  seldom  or  never  suffer 
from  it,  a  fact  which,  to  our  minds,  seems  difficult  of 
adequate  explanation.  Zundel  explains  this  by  stating 
that  contraction  is  principally  observed  in  the  fore-feet,  by 
reason  of  the  fact  that  when  lameness  arises  from  it  altera- 
tion in  action  will  more  readily  be  detected  in  front  than 
behind.  Percival,  on  the  other  hand,  suggests  that  the 
greater  expansive  powers  of  the  hind-foot,  by  reason  of 
the  impetus  of  its  action,  is  able  to  overcome  any  influence 
operating  towards  contraction.  It  may  be,  however,  that 
given  a  cause  for  contraction,  such  as  the  removal  of  the 
frog's  counter-pressure  with  the  ground  by  faulty  shoeing 
or  excessive  paring,  the  fore-feet,  by  reason  of  their  being 
called  upon  to  bear  the  greater  part  of  the  body-weight, 
are  the  first  to  suffer. 

Flat  feet  with  weak  heels  are  those  most  frequently 
affected,  and,  as  we  have  already  intimated,  the  conditio! 
may  exist  with  or  without  other  disease  of  the  foot. 

Depending  upon  its  degree,  contracted  foot  may  vary 
from  a  simple  abnormality,  non-inflammatory  and  painless, 
to  a  condition  in  which  it  becomes  a  veritable  disease, 
giving  rise  to  a  bad  form  of  lameness,  and  bringing  about 
a  withered  and  sometimes  discharging  and  cankerous 
affection  of  the  frog. 

Symptoms. — In  its  early  stages  contraction  is  difBcult  of 
detection,  and  where  both  feet  are  affected  may  for  some 
time  go  unsuspected.  With  only  one  foot  undergoing 
change,  the  early  stages  may  the  more  readily  be  marked, 
for  in  this  case  comparison  with  the  other  and  sound  foot 
will  at  once  reveal  the  alteration  in  shape.  If  lameness  in 
the  suspected  foot  is  present,  then  any  lingering  doubt  will 
be  quickly  dispelled. 

When  far  advanced,  contraction  offers  signs  that  cannot 

well  be  missed.     The  converging  of  the  heels  narrows  the 

V-shaped  indentation  in  the  sole  for  the  reception  of  the 

frog.     As  a  consequence  of  this,  the   frog  itself  becomes 


118        DISEASES  OF  THE  HORSE'S  FOOT 

atrophied  by  reason  of  the  continual  pressure  exerted  upon 
it  by  the  ingrowing  horn  of  the  wall  and  the  bars.  The 
median  and  lateral  lacuna?  of  this  organ,  from  being  fairly 
broad  and  open  channels,  become  pressed  into  mere  crack- 
like openings  (see  the  commencing  of  this  condition  in  Fig. 
SO,  and  a  badly  wasted  from  in  Fig.  74a).  As  the  case 
goes  on,  the  lateral  branches  of  the  frog  entirely  disappear, 
and  all  that  is  left  of  the  organ  is  a  remnant  of  its  body  or 
cushion,  now  wedged  in  tightly  between  the  bars.  Follow- 
ing upon  the  disappearance  of  the  frog,  we  find  that  the 
bars  are  in  contact,  or  in  some  cases,  actually  overlapping 
each  other  at  their  posterior  extremities. 

At  this  stage,  perhaps,  the  whole  condition  has  become 
aggravated  by  a  foul  discharge  from  the  place  originally 
occupied  by  the  frog,  and  the  foot,  especially  in  the  region 
of  the  heels,  has  become  hot  and  tender — really  a  form  of 
local  and  subacute  laminitis. 

The  long-continued  inflammation,  although  only  of  a  low 
type,  renders  the  horn  of  the  hoof  hard  and  dry,  and  only 
with  difficulty  will  the  ordinary  foot  instruments  cut  it. 
This  in  its  turn  leads  to  cracks  and  fissures  in  various 
places,  but  more  especially  in  the  bars  and  what  is  left  of 
the  frog-  Often,  too,  cracks  will  appear  in  the  horn  of  th  '- 
quarters,  and  a  troublesome  and  incurable  form  of  sand- 
crack  results. 

An  animal  with  contraction  advanced  as  far  as  this,  espe- 
cially if  confined  to  one  foot,  goes  unmistakably  lame. 
With  both  feet  affected,  he  ordinarily  starts  out  from  the 
stable  in  a  manner  that  is  commonly  called  4  groggy.'  In 
other  words,  the  gait  is  uncertain,  and  feeling;  and  stum- 
bling is  frequent.  Anyone  who  has  had  the  misfortune  to 
drive  an  animal  with  feet  in  this  condition  knows  full  well 
that  every  little  irregularity  in  the  road  at  once  makes  itself 
felt  to  the  feet,  and  that  the  animal,  as  time  goes  on,  learns 
to  carefully  avoid  any  suspicious-looking  group  of  stones 
he  may  see.  To  drive  an  animal  like  this  is  to  keep  one's 
self  continually  on  tenter-hooks,  for,  sooner  or  later,  the 
inevitable  happens,  and  the  animal  comes  down. 


FAULTY  CONFORMATION  119 

Up  to  now  we  have  described  the  changes  of  form  in  the 
hoof  as  seen  when  the  contracted  foot  is  viewed  from  tha 
solar  surface.  With  those  changes  as  evident  as  we  have 
depicted  them,  there  will  be  no  difficulty  in  detecting  the 
alterations  in  the  form  of  the  wall. 

In  addition  to  a  narrowing  from  side  to  side  there  will  be 
noticed  an  abnormal  straightness  of  the  quarters,  with  a 
turning  in,  more  or  less  sudden,  of  the  heels.  This  effect 
is  given  in  these  cases  by  the  smith  maintaining  the  shoe 
of  a  length  and  width  that  should  normally  fit  a  foot  of 
that  particular  animal's  size  and  substance.  This  is  prob- 
ably done  with  the  idea  of  deceiving  anyone  examining  the 
solar  surface.  Viewed  from  this  position,  the  width  of  the 
shoe  at  the  heels  gives  the  impression  that  it  is  attached  to 
a  foot  of  normal  breadth.  This  deception  is  heightened  if 
at  the  same  time  has  been  practised  the  process  of  '  open- 
ing up  the  heels.'  That  expression  indicates  that  the  bars 
have  been  removed,  and  the  lateral  lacunae  of  the  frog- 
made  to  continue  the  concavity  of  the  sole.  The  arch  of 
the  latter  is  thus  made  to  appear  of  much  greater  extent 
than  it  really  is,  and  the  heels,  by  reason  of  their  being 
abruptly  cut  off  when  removing  the  bars,  also  convey  the 
false  impression  of  being  wide  apart. 

The  practitioner  unversed  in  the  tricks  of  the  forge  will 
test  guard  against  this  by  viewing  the  foot,  while  on  the 
ground,  from  behind-  From  that  position  he  will  be  able 
to  detect  the  lowness  of  the  quarters,  and  the  projecting 
portion  of  the  shoe,  that  the  hoof,  by  reason  of  its  sudden 
bending  inwards,  does  not  touch. 

The  '  feeling '  manner  of  the  gait  before  alluded  to, 
together  with  the  disinclination  to  put  the  foot  firmly  and 
squarely  forward,  will  sometimes  lead  the  examiner  to  over- 
look the  contraction,  and  diagnose  his  case  as  one  of 
shoulder  lameness.  In  many  cases,  too,  such  consequent 
conditions  as  '  thrushy  frogs  '  and  '  suppurating  corns  '  are 
often  treated  with  utter  disregard  of  the  contraction  that 
has  really  brought  them  about.  But  above  all,  the  disease 
most  likely   to  be   confounded  with   simple   contraction   is 


120         DISEASES  OF  THE  HORSE'S  FOOT 

navicular  disease.  More  than  probable  it  is  that  many 
cases  of  so-called  '  navicular  '  have  in  reality  been  nothing 
more  than  contraction  brought  about  by  one  or  other  of  the 
causes  wq  shall  afterwards  enumerate — cases  where  a  due 
attention  to  the  prime  cause  of  the  mischief  would,  in  all 
likelihood,  have  remedied  the  lameness. 

Changes  in  the  Internal  Structures. — It  follows  as  a  mat- 
ter of  course  that  the  changes  we  have  described  in  the  form 
of  the  hoof  itself  carry  with  them  alterations  in  the  bones 
and  sensitive  structures  beneath  it.  The  tissues,  as  a  whole, 
become  atrophied.  The  os  pedis  becomes  deformed,  loses 
its  circular  shape,  and  gradually  becomes  more  or  less  oval 
in  contour.  At  the  same  time,  its  structure  becomes  more 
compact,  the  cribriform  appearance  of  its  anterior  and 
lateral  faces  more  or  less  destroyed,  and  the  few  remaining 
openings  apparently  increased  in  size.  This  atrophy  of  the 
os  pedis  is  best  noted  at  the  wings. 

In  the  plantar  cushion  the  effects  of  the  atrophy  are 
noted  in  the  smallness  of  the  organ,  in  its  becoming  whiter 
in  color  than  normal,  and  more  resistant  to  pressure. 

The  coronary  cushion  is  also  affected  in  the  same 
way,  where  the  changes  are  noted  most  in  its  posterior 
portions. 

A  further  effect  of  the  narrowing  of  the  heels,  and  their 
consequent  tendency  to  drop  downwards,  is  the  exertion  of 
a  continual  pressure  on  the  sensitive  sole.  In  course  of 
time,  and  especially  in  flat  feet,  this  leads  to  the  appearance 
of  corns. 

The  navicular  bone  and  bursa  and  the  tendon  of  the 
perforans  also  suffer  from  the  effects  of  compression-  The 
movement  of  the  tendon  is  restricted,  and  arterial  supply  to 
the  adjacent  structures  rendered  deficient.  The  tissues  of 
the  bone  and  bursa  are  insufficiently  nourished,  and  the 
secretion  of  synovia  lessened.  In  this  way  it  is  conceivable 
that  navicular  disease  may  follow  the  condition  of  simple 
contracted  heels. 

In  common  with  the  other  structures,  the  lateral  carti- 
lages also  suffer  from  the  continual  pressure.     Their  blood- 


FAULTY  CONFORMATION  121 

supply  is  lessened,  their  functions  interfered  with,  and  side- 
bones  result. 

Causes. — Upon  the  causation  of  contraction  a  very  great 
deal  has  been  written,  both  by  early  veterinarians  and  by 
those  of  the  present  day.  Many  and  widely  differing  opin- 
ions have  been  advanced,  but  a  careful  resume  of  only  a 
Few  will  lead  one  to  certain  fixed  conclusions. 

We  may  consider  the  causes  of  contraction  under  two 
headings — predisposing  and  exciting. 

Predisposing  causes  of  Contraction. — Among  these  we 
will  first  mention  heredity,  although  it  is  possible  it  should 
not  be  deemed  of  so  great  account  as  it  is  by  some.  That 
the  shape  of  certain  feet,  especially  those  with  low  heels  and 
abnormally  sloping  walls,  predisposes  to  contraction  no  one 
will  deny.  So  long,  however,  as  the  animal  goes  unshod, 
so  long  does  the  foot  maintain  a  normal  condition  of  the 
heels.  In  other  words,  it  is  not  until  the  tendency  to  con- 
traction already  there  is  aggravated  by  careless  shoeing  and 
the  effects  of  work  that  it  operates  to  any  noticeable  extent. 

The  degree  of  contraction  will  also  be  very  largely 
governed  by  the  amount  of  the  development  of  the  frog. 
With  a  frog  of  good  size,  low  down,  and  taking  part  in  the. 
pressure  of  the  foot  on  the  ground,  contraction  will  be  pre- 
vented. On  the  other  hand,  an  ill-developed  frog,  one 
wasted  by  long-continued  and  spreading  thrush,  or  one 
robbed  of  its  normal  function  by  excessive  paring  in  the 
forge,  is  a  common  starting-point  of  the  condition  we  are 
considering.  We  have  already  referred  to  this  in  Chapter 
III.,  when  considering  the  experiments  of  Lungwitz  in 
this  connection  What  we  have  to  bear  in  mind  in  these 
experiments  is  that  the  application  of  a  pad  to  the  frog,  in 
such  a  manner  that  effective  ground-pressure  is  obtained, 
results  always  in  a  marked  expansion  of  the  heels,  and 
that,  with  counter-pressure  with  the  ground  absent,  expan- 
sion occurs  to  little  or  no  extent.  This  is  proof  positive 
of  the  enormous  part  the  frog  plays  in  maintaining  an  open 
and  elastic  condition  of  the  heels — a  fact  so  insisted  on  by 
Coleman. 


122        DISEASES  OF  THE  HORSE'S  FOOT 

It  is  worthy  of  mention,  however,  that  loss  of  the  frog's 
function  does  not  operate  to  nearly  so  serious  an  extent  in 
horses  with  high,  upright  heels  as  in  those  with  the  heels 
low  and  excessively  sloping. 

In  illustrating  this,  Mr.  Dollar,  in  his  work  on  shoeing, 
mentions  the  case  of  a  pair  of  trotting  horses  of  similar 
age,  size,  and  weight,  each  having  weak  fore-heels.  In 
one  case  the  hoofs  were  flat,  in  the  other  upright.  The 
horse  with  the  flat  hoofs  suffered  from  contraction,  while 
the  other  did  not. 

The  reason  appears  to  be  that  in  the  animal  with  upright 
hoofs  the  proportion  of  body-weight  borne  by  the  heels  is 
considerably  less  than  in  those  with  the  hoofs  flat  and 
sloping. 

Certain  conditions  of  the  horn-producing  membranes  also 
predispose  to  contraction.  For  example,  in  horses  reared 
on  marshy  soils,  and  afterwards  transferred  to  standing  in 
town  stables,  we  find  that  a  dry  and  brittle  condition  of  the 
horn  supervenes.  This  we  may  regard  as  a  low  form  of 
laminitis,  brought  about  by  the  heat  of  the  material  upon 
which  the  animal  is  standing,  and  the  congestion  of  the 
feet  engendered  by  his  enforced  standing  for  long  periods 
in  one  position,  as  opposed  to  the  more  or  less  continuous 
exercise  when  at  pasture.  With  the  hoof  in  this  condition 
it  loses  by  evaporation  the  moisture  that  normally  it  should 
contain,  and,  as  we  might  expect,  a  certain  degree  of  con- 
traction of  its  structure  is  the  inevitable  result. 

We  thus  see  that  contraction  brought  about  in  this  way 
is  not  so  much  caused  by  the  heat  of  the  stable,  as  it 
is  by  the  decreased  ability  of  the  horn  to  retain  its  own 
moisture. 

On  the  other  hand,  it  cannot  be  denied  that  excessive 
warmth  and  dryness  combined  tend  also  to  an  undue 
abstraction  of  moisture,  even  from  the  horn  of  the  healthy 
foot;  and  this  explains  in  great  measure  how  it  is  that 
lameness,  as  a  rule,  and  especially  that  proceeding  from 
contracted  heels,  is  far  more  frequent  and  of  greater  in- 
tensity  in  the   hot,   dry   months   of    summer,   than   in   the 


FAULTY  CONFORMATION  123 

cooler  and  more  humid  atmosphere  of  winter.  It  is  inter- 
esting to  note,  too,  that  an  alternation  of  humidity  and  dry- 
ness is  far  more  liable  to  injure  the  quality  of  the  horn  and 
tend  to  its  contraction  than  the  long-continued  effects  of 
dryness  alone  A  common  illustration  of  this  is  to  be 
found  in  the  effects  of  the  ordinary  poultice.  Everyone 
knows  that  when,  after  a  few  days'  application,  they  are 
discontinued,  we  get  as  a  result  an  abnormally  dry  and 
brittle  state  of  the  horn.  This  is  doubtless  due  to  the 
poultice  removing  this  thin,  varnish-like,  and  protective 
pellicle  known  as  the  periople,  and  thereby  allowing  the 
process  of  evaporation  to  act  on  the  water  normally  con- 
tained in  the  hoof. 

Exciting  Causes  of  Contraction. — Among  these,  first  place 
must  undoubtedly  be  given  to  shoeing.  This  does  not 
necessarily  imply  shoeing  more  than  ordinarily  faulty,  nor 
a  faulty  preparation  of  the  foot,  but  shoeing  as  it  is  gener- 
ally practised.  No  ordinary  shoe,  except  a  few  devised  for 
the  purpose,  such  as  the  Charlier  or  the  tip,  allows  the  frog 
to  come  in  contact  with  the  ground.  This  we  take  to  be 
the  main  factor  in  the  causation  of  contracted  heels,  espe- 
cially with  a  predisposition  already  present  in  the  foot  it- 
self. In  the  words  of  Lungwitz :  '  Regarded  from  this 
point  of  view,  there  is  no  greater  evil  than  shoeing.  It 
abolishes  the  necessary  counter-pressure,  and  thus  inter- 
feres with  expansion.  Bars,  sole,  and  frog  cannot  perform 
the  functions  that  naturally  belong  to  them  as  they  would 
do  without  the  shoe.' 

In  addition  to  the  evil  of  the  shoe  itself,  errors  of  prac- 
tice in  the  forge  contribute  to  the  causation  of  contraction. 
Taking  first  the  preparation  of  the  foot,  we  find  that  often 
the  heels  are  lowered  far  too  much,  and  the  toe  allowed  to 
remain  too  long.  This  can  have  but  one  effect — that  of 
throwing  a  greater  proportion  of  the  animal's  wreight  upon 
the  heels  than  properly  they  should  bear,  with,  what  we 
now  know  to  be  the  consequence  of  that,  a  corresponding 
pushing  inwards  and  downwards  of  the  horn ;  in  other 
words,  contraction. 


124         DISEASES  OF  THE  HORSE'S  FOOT 

Excessive  paring  of  the  bars,  to  which  we  have  already 
partly  alluded,  is  also  an  active  agent  in  bringing  about  an 
inward  growth  of  the  horn  of  the  heels  and  quarters.  The 
bar,  or  inflexion  of  the  wall  at  the  heel,  by  means  of  its 
close  contact  with  the  frog,  communicates  the  outward 
movements  of  that  organ  to  the  wall  of  the  hoof.  With  the 
bar  removed,  the  outward  movements  of  the  frog  under  pres- 
sure are  naturally  rendered  of  no  account,  and  a  proper  anr1. 
intermittent  expansion  of  the  wall  denied  it.  The  same  evil 
fellows,  though  to  a  less  extent,  excessive  paring  of  the  sole. 

The  shape  of  the  bearing  surface  of  the  shoe  is  often  to 
be  blamed.  (Where  this  is  concave — '  seated ' — and  the 
'  seating '  is  carried  back  to  the  heels,  it  is  easy  to  see  that, 
when  weight  is  on  the  foot,  there  is  an  ever-present  ten- 
dency for  the  bearing  edge  of  the  wall  to  slide  down  to- 
wards the  inner  edge  of  the  shoe.  This  tendency,  operat- 
ing on  both  the  inner  and  outer  wall  simultaneously,  must 
strongly  favour  contraction. 

A  further  wrong  practice  is  that  of  continuing  the  nail- 
ing too  far  towards  the  heels.  In  our  opinion  this  is  not 
now  often  met  with.  When  it  occurs  its  effect  is,  of  course, 
to  prevent  those  movements  of  expansion  of  the  wall  which 
we  now  know  to  be  normal  and  most  marked  at  the  heels. 

It  may  be  remarked  of  the  build  of  the  shoe,  or  of  errors 
in  the  preparation  of  the  foot,  that  neither  are  of  much 
moment.  Neither  are  they.  But  when  one  stays  to  con- 
sider that  errors  of  this  description  are  practised  not  only 
once,  but  each  time  the  horse  goes  to  the  forge,  and  that 
with  some  of  them — those  relating  to  the  build  of  the  shoe 
— the  injury  thereby  brought  about  is  inflicted  not  only 
once,  but  every  day  that  particular  shoe  is  worn,  then  it  is 
not  to  be  wondered  at  that,  sooner  or  later,  ill  consequences 
more  or  less  grave  result. 

Prognosis. — This  will  depend  to  a  very  large  extent  upon 
the  conformation  of  the  limb,  and  upon  the  previous  dura- 
tion of  the  contraction.  Contraction  of  long  standing, 
where  atrophy  of  the  sub-lying,  soft  structures  and  the 
pedal  bone  may  be  expected,  will  prove  obstinate  to  treat- 


FAULTY  CONFORMATION  12= 

ment.  Especially  will  this  be  so  if  the  lateral  cartilages 
have  become  ossified.  Neither  may  we  look  for  mucL 
benefit  from  treatment  if  the  contraction  has  occurred  in 
animals  with  an  oblique  foot  axis  and  flat  hoofs. 

On  the  other  hand,  if  the  case  is  comparatively  recent,  if 
the  limb  is  straight  and  the  form  of  the  hoof  is  upright, 
and  if  matters  are  uncomplicated  by  side-bones,  or  other 
serious  alteration  in  the  internal  structures,  then  treatment 
may  be  rewarded  with  some  measure  of  success- 

Treatment. — The  greater  part  of  the  treatment  of  con- 
tracted foot  will  almost  suggest  itself  as  a  corollary  of  the 


Fig.  63.— Tip  Shoe. 

The  dotted  portions  represent  the  length  of  the  branches  removed. 

causes  we  have  enumerated.  The  normal  width  of  the 
heels  may  be  renewed,  and  development  of  the  wasted  frog 
brought  about  by  one  of  three  methods : 

1.  By  restoring  the  pressure  from  below  to  the  frog. 

2.  By  the  use  of  an  expansion  shoe. 

3.  By  operative  measures  upon  the  horn  of  the  wall. 
1.  By  Restoring  the  Pressure  from  Below  to  the  Frog. 
This  may  be  accomplished  as  follows : 

(a)  By  Shoeing  with  Tips. — This  method  is  advocated 
by  l-ercfval,  by  A-  A.  Holcombe,  D.V.S.,  Inspector,  Bureau 
of  Animal  Industry,  U.S.A.,  by  Dollar  in  his  work  on  horse- 
shoeing, and  by  many  others. 

Though  requiring  more  care  than  in  fitting  the  ordinary 


126        DISEASES  OF  THE  HORSE'S  FOOT 

shoe,  the  application  of  a  tip  is  simple.  In  reality,  the  tip 
is  just  an  ordinary  shoe  shortened  by  truncating  the  heels. 

Before  applying  the  tip,  the  horn  of  the  wall  at  the  toe 
should  be  shortened  sufficiently  to  prevent  any  undue 
obliquity  of  the  hoof,  and  the  foot  should  be  so  prepared  as 
to  allow  the  heels  of  the  tip  to  sink  flush  with  the  bearing 
edge  of  the  wall  behind  it. 

When  the  foot  does  not  allow  of  the  removal  of  much 
horn  at  the  toe,  what  is  termed  a  '  thinned  '  tip  is  to  be 
preferred.  Its  shape  is  sufficiently  shown  by  the  accom- 
panying figure  (Fig.  65). 

With  the  tip  the  posterior  half  of  the  foot  is  allowed  to 
come  into  contact  with  the  ground,  and  the  object  we  are 


Fig.  65.— The  Thinned 
Tip. 


Fig.  64.— The  Tip  Shoe  'let  in' 
the  Foot. 


striving  for — namely,  frog  pressure,  and  greater  facilities 
for  alternate  expansion  and  contraction  of  the  heels — is 
thus  brought  about. 

(b)  By  Shoeing  with  the  Charlier. — The  results  brought 
about  by  the  use  of  a  tip  may  be  arrived  at  by  the  applica- 
tion of  a  Charlier  or  preplantar  shoe,  or  by  a  modified 
Charlier  or  Charlier  tip. 

Briefly  described,  a  Charlier  is  a  shoe  that  allows  the 
sole  and  the  frog  to  come  to  the  ground  exactly  as  in  the 
unshod  foot.  This  is  accomplished  by  running  a  groove 
round  the  inferior  edge  of  the  hoof  by  removing  a  portion 
of  the  bearing  edge  of  the  wall  with  a  specially  devised 
drawing-knife. 


FAULTY  CONFORMATION 


127 


Into  this  groove  is  fitted  a  narrow  and  somewhat  deep 
shoe,  made,  preferably,  of  a  mixture  of  iron  and  steel,  and 
forged  in  such  a  manner  that  its  front  or  outer  surface 
follows  the  outer  slope  of  the  wall- 

The  Charlier  should  have  the  inner  edge  of  its  upper 
surface   very    slightly   bevelled,    in    order   to    prevent    any 


Fig.  66. — The  Special  Drawing-knife  (Fleming's)  for  preparing 
the  Foot  for  the  Charlier  Shoe. 

pressure  on  the  sensitive  sole,  and  should  be  provided  with 
from  four  to  six  nail-holes.  These  latter  should  be  small 
in  size  and  conical  in  shape.  The  nails  themselves  should 
be  small,  and  have  a  conical  head  and  neck,  to  fit  into  the 
nail-hole  of  the  shoe. 

The  modified  Charlier,  or  Charlier  tip,  perhaps  the  bet- 
ter of  the  two  for  the  purpose  we  are  describing,  is  really 


Fig.  67. — Foot  prepared  for  the  Charlier  Shoe. 


a  shortened  Charlier,  and  bears  the  same  relation  to  the 
Charlier  proper  as  the  tip  does  to  the  ordinary  shoe.  It  is 
let  into  the  solar  surface  of  the  foot  in  exactly  the  same 
manner  as  its  larger  fellow,  but  it  does  not  extend  back- 
wards beyond  the  commencement  of  the  quarters.  By  its 
use  greater  opportunity  for  expansion  is  given  to  the  heels 
than  is  done  by  the  Charlier  with  heels  of  full  length. 


128        DISEASES  OF  THE  HORSE'S  FOOT 

We  do  not  here  intend  to  deal  at  any  length  with  the 
arguments  for  and  against  the  Charlier  as  regards  its  adop- 
tion for  general  use.  These  will  be  found  fully  set  out  in 
any  good  work  on  shoeing. 

The  point  that  it  is  correct  in  theory  it  would  be  idle, 
to  attempt  to  evade;  but  that  it  is  generally  practicable, 
or  that  it  offers  any  very  pronounced  advantages,  as  com- 
pared with  the  disadvantages  urged  against  it,  over  the 
shoes  in  ordinary  use,  the  limited  favour  it  has  drawn  to 
itself,  since  its  introduction  in  1865,  seems  sufficiently  to 
deny. 

(c)  By  the  Use  of  a  Bar  Shoe. — Where  the  frog  is  not 
excessively  wasted  benefit  will  be  derived  from  the  use  of  a 
bar  shoe. 


Fig.  68.— Bar  Shoe. 

The  transverse  portion  at  the  back,  termed  the  '  bar,' 
and  which  gives  the  shoe  its  name,  is  instrumental  in 
bringing  about  from  below  that  counter-pressure  on  the 
frog  that  we  now  know  to  be  so  necessary  a  factor  in 
remedying  contraction.  When  the  frog,  by  wasting  of 
disease,  is  so  deficient  as  to  be  unable  to  reach  the  '  bar/ 
this  shoe  must  be  supplemented  by  a  leather  or  rubber 
sole. 

In  the  event  of  corn  or  sand-crack  existing  with  the 
contraction,  the  shoe  known  as  a  '  three-quarter  bar  '  is 
preferable  (see  Fig.  103).  The  break  here  made  in  the 
contour  of  the  shoe  allows  of  dressing  the  corn,  and,  in  the 
case  of  sand-crack,  removes  the  bearing  from  that  portion 
of  the  wall- 


FAULTY  CON FORMATION 


129 


(d)  By  the  Use  of  a  Bar  Pad  and  a  Heelless  or  '  Half  ' 
Shoe. — The  bar  pad  consists  of  a  shape  of  rubber  com- 
position firmly  fixed  to  a  leather  foundation,  which  shape 
of  rubber  takes  the  place  of  the  '  bar  '  of  the  bar  shoe. 


Fig.  69.— Rubber  Bar  Pad  on 
Leather. 


Fig.  70.— The  Bar  Pad  applied 
with  a  Half-shoe. 


For  habitual  use  in  such  cases  as  prove  obstinate  to  treats 
ment,  or  where  a  complete  cure  was  never  from  the  com- 
mencement expected,  the  bar  pad  is  undoubtedly  one  of 
the  most  useful  inventions  to  our  hand.  The  animal's 
'going'   is   improved,   the   tender   frog   is   protected    from 


Fig.  71.— Frog  Pad.  Fig.  72.— Frog  Pad  applied. 


injury  by  loose  stones,  and  greater  comfort  given  to  both 
the  horse  and  the  driver. 

0)  By  the  Use  of  a  Frog  Pad  and  a  Shoe  of  Ordinary 
Shape.— The  shape  of  rubber  on  this  pad  is  designed  to 
cover  the  frog  only.  Its  shape  and  mode  of  application  is 
sufficiently  shown  in  the  accompanying  illustrations. 


150 


DISEASES  OF  THE  HORSE'S  FOOT 


(/)  By  turning  out  to  Grass. — Where  the  expense  of  keep 
is  no  object,  a  return  of  contracted  feet  to  the  normal  may 
be  brought  about  by  removing  the  shoes  and  turning  the 
animal  out  to  pasture,  thus  giving  the  feet  the  advantages 
to  be  derived  from  a  more  or  less  continuous  operation  of 
the  normal  movements  of  expansion  and  contraction.  In 
this  case  the  treatment  must  extend  from  three  to  four,  or 
possibly  six  months. 

2.    By  the  Use  of  Some  Form  of  Expansion  Shoe. 

(a)  Smith's. — For  many  years  past  continental  writers 
have  been  practising  this  method.    So  far  as  we  know,  how- 


Fig.  73. — Smith's  Expansion  Shoe  seen  from  its  Ground  Surface 
and  from  the  Side. 

a,  The  screw,  with-  a  fine-cut  thread ;  b,  nut  which  travels  along  it ; 
c,  ahollow  thimble  into  which  the  screw  passes  at  one  end,  the 
other  being  cut  out  V-shaped  to  catch  into  a  slot  (d)  on  the 
shoe ;  e,  e,  the  grip*  for  the  bars,  the  length  and  direction  of 
which  depend  upon  the  shape  of  the  foot ;  /,  f,  the  counter-sunk 
rivets  forming  the  hinge  (/)  ;  g,  the  counter-sung  rivet  of  the 
expanding  piece. 

ever,  Lieutenant-Colonel  Fred  Smith  was  the  first  English 
veterinarian  to  use  a  shoe  of  his  own  devising,  and  to  report 
on  its  effects.  This  shoe  we  will,  therefore,  give  first  men- 
tion- 

The    above    figure,    with    its    accompanying    letterpress, 
sufficiently  explains  the  nature  of  the  shoe.     In  fitting  the 

*  The  inventor  of  this  shoe  uses  the  word  '  grip  '  to  denote  what, 
in  describing  other  expansion  shoes,  we  term  the  'clip'  (H.  C.  R.). 


FAULTY  CONFORMATION  131 

shoe,  care  must  be  taken  to  have  the  hinges  (f,  f )  far  enough 
Lack,  or  the  shoe  will  have  a  tendency  to  spring  at  the  heels, 
and  the  grips  (e,  e),  which  catch  on  the  bars,  will  have  a 
difficulty  in  biting.  This  trouble  will  be  avoided  by  having 
the  hinges  about  H  to  2  inches  from  the  heels. 

After  the  shoe  has  been  firmly  nailed  to  the  foot,  the 
travelling  nut  b  is  driven  forward  on  the  screw  a  so  as  to 
cause  the  grips  to  just  catch  on  the  inside  of  the  bars  of 
the  foot.  According  to  the  inventor,  the  amount  of  pressure 
to  be  exerted  must  be  learned  by  experience,  and  he  says : 

'  I  screw  up  very  gradually  until  I  see  the  cleft  of  the 
frog  just  beginning  to  open.  I  now  trot  the  horse  up,  and 
if  he  goes  sound  it  is  certain  that  the  pressure  I  have  exer- 
cised will  not  give  rise  to  trouble.  The  animal  is  sent  to 
work  to  assist  in  the  expansion  of  the  foot-  On  examining 
the  shoe  next  day,  the  grip  is  found  to  be  quite  loose,  the 
foot  has  enlarged,  and  the  nut  is  turned  once  more  until 
the  grip  on  the  bars  is  tightened,  the  horse  being  again 
trotted  to  ascertain  that  no  injurious  pressure  is  exerted. 

'  Every  day  or  two  I  repeat  this  process,  making  measure- 
ments in  all  cases  before  widening  the  heels.  The  increase 
in  width  of  the  foot  which  results  is  astonishing,  \  to  f  inch 
during  the  first  week  may  be  safely  predicted,  and  in  a 
month  to  six  weeks  it  is  impossible  to  recognise  in  the  large 
healthy  frog  and  wide  heels,  the  shrivelled-up  organ  of  a 
short  time  before.'* 

It  is  pointed  out  by  the  writer  of  the  above  (and  his 
observations,  doubtless,  apply  to  the  use  of  all  other  expan- 
sion shoes  in  which  the  bars  are  gripped  and  forcibly  ex- 
panded) that  the  whole  secret  of  success  lies  in  avoiding 
injurious  pressure  by  exerting  too  great  an  expansion  at 
cne  operation.  After  each  manipulation  of  the  expanding 
apparatus  the  horse  should  trot  sound  and  the  frog  remain 
cool.  Should  the  foot  become  hot,  and  lameness  supervene, 
then  tension  should  at  once  be  relaxed. 

Recorded  Cases  of  the  Use  of  the  Shoe. — The  inventor  of 

*  Journal  of  Comparative  Pathology  and  Therapeutics,  vol.  v., 
P-98. 


132        DISEASES  OF  THE  HORSE'S  FOOT 

the  shoe  relates  two  cases  of  contracted  foot  treated  by 
these  means  in  which  the  heels  of  one,  after  thirty-nine 
days'  treatment,  had  increased  in  width  to  the  extent  of 
1  inch,  and  the  heels  of  the  other,  after  twenty-four  da} 
had  enlarged  f  inch.  Of  the  first  case  he  gives  the  draw- 
ings in  Fig.  74. 

A  represents  the  foot  before  treatment;  B  the  same 
foot  after  nine  days'  treatment,  when  the  heels  had 
widened  J  inch;  and  C  the  same  foot  at  the  end  of  the 
thirty-nine  days'  treatment,  at  which  date  the  frog  was  an 
excellent-looking  one,  and  the  foot  had  increased  an  inch 
in  width.* 


Fig.  74_The  Changes  in  Form  of  a  Contracted  Foot  treated 
with  Smith's  Expansion  Shoe. 

In  1893,  at  a  meeting  of  the  Midland  Counties  Veterinary 
Medical  Association,  the  late  Mr.  Olver  said  he  had  applied 
this  shoe  to  a  valuable  hunter  that  had  gone  so  lame  that 
he  could  scarcely  put  his  foot  to  the  ground.  After  a  fort- 
night's application,  and  by  the  assistance  of  the  double 
screw  in  the  shoe,  the  heel  was  forced  out.  Then  the  horse 
was  put  to  work  with  the  shoe  on,  and  he  had  hunted  the 
whole  of  the  last  season  in  a  perfectly  sound  condition.! 

F.  D.  McLaren,  M.R.C.V.S.,  writes:*     '  I  resolved  to  try 


*  Journal   of   Comparative   Pathology  and   Therapeutics,  vol.   v. 
p.   ioo. 

t   Veterinary  Record,  vol.  vi.,  p.  143. 
t  Ibid.,  vol.  vi.,  p.  i83. 


FAULTY  CONFORMATION  133 

one  of  Captain  Smith's  shoes  in  a  case  where  the  hoof  was 
badly  contracted,  and  where  the  frog  had  entirely  disap- 
peared, there  being  also  slight  lameness.  The  hoof  rapidly 
expanded,  and  every  other  day  the  nut  was  moved  on  a  bit 
to  keep  the  cross-piece  tight.  I  then  had  the  cross-piece 
bent  downwards  a  little  to  prevent  the  nut  pressing  on  the 
>•  a p idly-growing  frog-*  After  another  fortnight  or  so,  I 
had  a  shoe  made  with  clips  resting  against  the  inside  of  the 
bars,f  and  the  next  time  he  wras  shod  these  were  also  dis  • 
pensed  with.  It  is  now  a  year  ago  since  the  animal  re- 
covered his  frog,  and  he  still  has  the  largest  frog  in  the 
stable,  and  the  hoof  shows  no  sign  of  contraction.' 

(b)  De  Fay's. — Among  other  shoes  of  the  expansion 
class  may  be  mentioned  that  of  De  Fay-  Like  the  pre- 
ceding, it  is  a  shoe  with  a  flat  bearing  surface,  and  pro- 
vided with  bar-clips.  It  is,  however,  wnhinged.  The  re- 
quisite degree  of  periodic  expansion  is  in  this  case  arrived 
at  by  a  forcible  widening  of  the  heels  of  the  shoe,  accom- 
plished by  bending  the  substance  of  which  it  is  made,  and 
for  this  purpose  the  instrument  illustrated  in  Fig.  75  is 
employed. 

The  foot  is  first  properly  trimmed  by  levelling  the  heels 
and  thinning  the  sole  on  each  side  of  the  frog.  The  shoe 
is  then  fixed  by  nails  in  the  ordinary  manner,  taking  care 
that  the  last  nails  come  not  too  far  back,  and  that  the  clips 
rest  evenly  and  firmly  on  the  inside  of  the  bars. 

The  dilator,  hoof-spreader,  or  vice,  as  it  is  variously 
called,  is  then  applied,  its  two  jaws  (a  and  b)  fitting  agains 
the  inner  edge  of  the  shoe  at  the  heels.  Careful  note  ii. 
taken  of  the  width  of  the  hoof  as  measured  on  the  gradu- 
ated scale  {e,  e),  and  the  double  screw  (g,  h)  revolved  by 
means  of  the  wrench  (k),  until  the  opening  of  the  jaw. 
thus  obtained  registers  an  expansion  of  1/12  to  -J  inch. 

The  dilatation  is  repeated  at  intervals  of  from  eight  to 
ten  days,  until,  at  the  expiration  of  a  month  or  six  weeks. 

*  The  italics  are  mine    (H.  C.  R.) 

t  The  expanding  shoe  itself  was  here  evidently  dispensed  with, 
and  an  ordinary  shoe  with  bar-clips  used  in  its  stead  (H.  C.  R.). 


134        DISEASES  OF  THE  HORSE'S  FOOT 

the  amount  of  total  expansion  of  the  heels  registers  nearly 
ar  inch.  That  the  method  requires  the  greatest  care  may 
be  gathered  from  the  reports  of  continental  writers.  They 
state  that  frequently  the  pain  and  consequent  lame- 
ness keep  the  patient  confined  to  the  stable  for  several 
days. 

Numerous  and  but  slightly  differing  forms  of  the  dilator 


'MIS 

jjjfjjj 

W|  J 

ggSjpgMI 

in 

Fig.  75.— De  Fay's  Vice. 

are  on  the  market.  As  in  principle  they  are  all  essentially 
the  same,  and  are  to  be  found  illustrated  in  any  reliable 
instrument  catalogue,  they  need  no  description  here. 

(c)  Hartmanris. — A  further  useful  expansion  shoe  is 
that  of  Hartmann's  (Fig.  76),  in  that  it  may  be  adapted  for 
either  unilateral  or  bilateral  contraction.  This  shoe  is  also 
provided  with  bar-clips,  and  forcibly  expanded  at  the  heels 
by  means  of  a  dilator.  The  expansion  is  governed  by  saw-* 
cuts  through  the  inner  margin  of  the  shoe  directed  towards 


FAULTY  CONFORMATION 


135 


its  outer  margin,  and  running  only  partially  through  the 
inner  half  of  the  web  (  see  Fig.  76). 

According  as  the  contraction  is  confined  to  the  inner  or 
outer  heel,  the  saw-cuts,  one  or  two  in  number,  are  placed 
to  the  inner  or  outer  side  of  the  toe-clip.  When  the  con- 
traction is  bilateral,  the  saw-cuts,  one  or  more  in  number, 
are  placed  on  each  side  of  the  toe-clip. 

(d)  Broucs. — This  is  one  of  the  forms  of  so-called 
'slipper'  shoes  (see  Fig.  77).  We  have  already  indicated 
that  the  shape  of  the  bearing  surface  of  the  ordinary  shoe 
— by   its    '  seating  '   or   sloping   from   outside   to   inside — is 


Fig.  76. 

This  figure  illustrates  the  principles  of  the  Hartmann  expanding 
shoe,    a,  a,  The  clips  to  catch  the  inside  of  the  bars;  b,  c,  saw-cuts. 

sometimes  a  cause  of  contraction.  In  the  '  slipper  '  of 
.Broue  this  bearing  is  reversed,  and  the  slope  is  from  inside 
to  outside.  In  the  original  form  of  this  shoe  the  slope  to  the 
outside  was  continued  completely  round  the  shoe.  Experi- 
ence taught  that  the  strain  this  enforced  upon  the  junction 
of  the  wall  with  the  sole  was  injurious,  and  that  the  '  re- 
versed seating,'  if  we  may  so  term  it.  was  best  confined  to 
the  hinder  portions  of  the  shoe's  branches. 

The  amount  of  slope  should  not  be  excessive-  If  it  is 
too  rapid  and  too  forcible  an  expansion  takes  place,  and 
pain  and  severe  lameness  results.    Dollar  gives  the  requisite 


138        DISEASES  OF  THE  HORSE'S  FOOT 

applied,  and  a  hoof  with  heels  of  a  wider  pattern  com- 
mences to  grow  down  from  the  coronet.  Two  to  three 
months'  rest  is  necessary  before  the  animal  can  again  be 
put  to  work.* 

(b)  Thinning  the  Wall  in  the  Region  of  the  Toe. — This 
is  done  with  the  idea  that  the  tendency  of  the  heels  to 
expand  under  pressure  of  the  body-weight  is  helped  by  the 
thinned  portion  at  the  toe  allowing  the  heels  to  more  readily 
open  behind-  Seeing  that  in  the  case  of  toe  sand-crack  the 
converse  is  argued — that  contraction  of  the  heels  readily 
takes  place  and  forces  the  sand-crack  wider  open  —  it  is 
doubtful  whether  this  method  is  of  any  utility  in  treating 
contracted  heels. 

(c)  Grooving  the  Wall  Vertically  or  Horizontally,  and 
Shoeing  zvith  a  Bar  Shoe. — Marking  the  wall  with  a  series 
of  grooves,  each  running  in  a  more  or  less  vertical  direc- 
tion, was  suggested  to  English  veterinarians  by  Smith's 
operation  for  side-bones. 

The  manner  of  making  the  grooves,  and  the  instruments 
necessary,  will  be  found  fully  described  in  Section  C  of 
Chapter  X. 

That  the  mehod  is  followed  by  satisfactory  results  the 
under  mentioned  case  will  show : 

'A  mare,  which  I  have  had  in  my  possession  since  she 
was  a  foal,  has  always  had  contracted  feet,  which  were  also 
unnaturally  small.  .  .  .  Lately  the  mare  has  been  going 
very  "short,"  and  at  length  her  action  was  quite  crippled. 
At  times  she  was  decidedly  lame  on  the  off  fore-foot.  At 
no  time  have  I  been  able  to  detect  any  sign  of  structural 
disease.  I  thereupon  concluded  that  the  lameness  was  due 
to  mechanical  pressure  on  the  sensitive  structures,  and  I 
determined  to  try  the  effects  of  the  above  treatment.  As 
this  was  my  first  experience  of  the  process,  I  was  careful  to 
carry  it  out  in  all  its  details,  as  described  by  Professor 
Smith.  After  the  bar  shoes  had  been  put  on,  the  mare 
was  very  lame.     I  allowed  her  two  days'  rest,  then  com- 

*  This  is  the  treatment  strongly  advocated  by  A.  A.  Holcombe, 
D.V.S.,   Inspector,   Bureau  of  Animal  Industry,  U.S.A. 


FAULTY  CONFORMATION  139 

menced  regular  walking  exercise,  and  she  daily  improved. 
After  fourteen  days  there  was  no  lameness,  but  still  short 
action.  I  thereupon  gave  the  mare  another  week's  walking 
exercise,  at  the  expiration  of  which  I  drove  her  a  short 
turn  of  five  miles,  which  she  did  quite  well,  and  free  from 
lameness.  For  three  months  I  kept  the  saw-cuts  upen  to 
the  coronet,  and  continued  the  bar  shoes,  keeping  the  marc 
at  exercise,  and  giving  her  occasionally  a  drive.  She  never 
liked  the  bar  shoes,  and  I  was  glad  when  I  could  discon- 
tinue them,  which  I  did  in  the  fourth  month.  When  shod 
with  the  usual  shoes  the  complete  success  of  the  treatment 
was  shown.  I  have  now  had  her  going  with  the  ordinary 
shoes  for  the  past  two  or  three  months,  and  the  improve- 
ment in  the  shape  of  the  feet  is  very  marked;  there  is 
no  lameness ;  the  mare  is  free  in  movement,  fast,  and 
spirited,  whereas  previously  she  was  quite  the  reverse,  and 
aimost  unfit  to  drive. '* 

This  method,  though  but  recently  introduced  to  the 
English  veterinary  surgeon,  is  by  no  means  new.  Accord- 
ing to  Zundel,  it  was  recently  made  known  on  the  Conti- 
nent by  Weber,  but  was  previously  known  and  mentioned 
by  Lagueriniere,  Brognier,  and  Hurtrel  d'Arboval. 

When  the  grooving  is  in  a  horizontal  direction,  a  single 
incision  is  sufficient.  This  is  made  j  inch  below  the 
coronary  margin  of  the  wall,  and  parallel  with  it,  extend- 
ing from  the  point  of  the  heel  for  2  or  3  inches  in  a  forward 
direction.  As  in  the  previous  method,  a  bar  shoe  is  applied, 
and  the  animal  daily  exercised.  Thus  separated  from  the 
fixed  and  contracted  portion  of  the  wall  below,  the  more 
clastic  coronet  under  pressure  of  the  body-weight  com- 
mences to  bulge.  The  bulging  is  of  such  an  extent  as  to 
cause  the  new  growing  hoof  from  the  top  to  considerably 
overhang  the  contracted  portion  below,  and  cure  of  the 
condition  results  from  the  newly-expanded  wall  above 
growing  down  in  a  normal  direction. 

This  consideration  of  contracted  heels  may  be  concluded 
by  drawing  attention  to  the  advisability  of  always  main- 

*  W.  S.  Adams,  M.R.C.V.S.,  Veterinary  Journal,  vol.  xxx.,  p.  19. 


138        DISEASES  OF  THE  HORSE'S  FOOT 

applied,  and  a  hoof  with  heels  of  a  wider  pattern  com- 
mences to  grow  down  from  the  coronet.  Two  to  three 
months'  rest  is  necessary  before  the  animal  can  again  be 
put  to  work.* 

(b)  Thinning  the  Wall  in  the  Region  of  the  Toe. — This 
is  done  with  the  idea  that  the  tendency  of  the  heels  to 
expand  under  pressure  of  the  body-weight  is  helped  by  the 
thinned  portion  at  the  toe  allowing  the  heels  to  more  readily 
open  behind-  Seeing  that  in  the  case  of  toe  sand-crack  the 
converse  is  argued — that  contraction  of  the  heels  readily 
takes  place  and  forces  the  sand-crack  wider  open  —  it  is 
doubtful  whether  this  method  is  of  any  utility  in  treating 
contracted  heels. 

(c)  Grooving  the  Wall  Vertically  or  Horizontally,  and 
Shoeing  with  a  Bar  Shoe. — Marking  the  wall  with  a  series 
of  grooves,  each  running  in  a  more  or  less  vertical  direc- 
tion, was  suggested  to  English  veterinarians  by  Smith's 
operation  for  side-bones. 

The  manner  of  making  the  grooves,  and  the  instruments 
necessary,  will  be  found  fully  described  in  Section  C  of 
Chapter  X. 

That  the  mehod  is  followed  by  satisfactory  results  the 
under  mentioned  case  will  show : 

'A  mare,  which  I  have  had  in  my  possession  since  she 
was  a  foal,  has  always  had  contracted  feet,  which  were  also 
unnaturally  small.  .  .  .  Lately  the  mare  has  been  going 
very  "short,"  and  at  length  her  action  was  quite  crippled. 
At  times  she  was  decidedly  lame  on  the  off  fore-foot.  At 
no  time  have  I  been  able  to  detect  any  sign  of  structural 
disease.  I  thereupon  concluded  that  the  lameness  was  due 
to  mechanical  pressure  on  the  sensitive  structures,  and  I 
determined  to  try  the  effects  of  the  above  treatment.  As 
this  was  my  first  experience  of  the  process,  I  was  careful  to 
carry  it  out  in  all  its  details,  as  described  by  Professor 
Smith.  After  the  bar  shoes  had  been  put  on,  the  mare 
was  very  lame.     I  allowed  her  two  days'  rest,  then  com- 

*  This  is  the  treatment  strongly  advocated  by  A.  A.  Holcombe, 
D.V.S.,   Inspector,   Bureau  of  Animal  Industry,  U.S.A. 


FAULTY  CONFORMATION  139 

menced  regular  walking  exercise,  and  she  daily  improved. 
After  fourteen  days  there  was  no  lameness,  but  still  short 
action.  I  thereupon  gave  the  mare  another  week's  walking 
exercise,  at  the  expiration  of  which  I  drove  her  a  short 
turn  of  five  miles,  which  she  did  quite  well,  and  free  from 
lameness.  For  three  months  I  kept  the  saw-cuts  upen  to 
the  coronet,  and  continued  the  bar  shoes,  keeping  the  marc 
at  exercise,  and  giving  her  occasionally  a  drive.  She  never 
liked  the  bar  shoes,  and  I  was  glad  when  I  could  discon- 
tinue them,  which  I  did  in  the  fourth  month.  When  shod 
with  the  usual  shoes  the  complete  success  of  the  treatment 
was  shown.  I  have  now  had  her  going  with  the  ordinary 
shoes  for  the  past  two  or  three  months,  and  the  improve- 
ment in  the  shape  of  the  feet  is  very  marked;  there  is 
no  lameness ;  the  mare  is  free  in  movement,  fast,  and 
spirited,  whereas  previously  she  was  quite  the  reverse,  and 
almost  unfit  to  drive. '* 

This  method,  though  but  recently  introduced  to  the 
English  veterinary  surgeon,  is  by  no  means  new.  Accord- 
ing to  Zundel,  it  was  recently  made  known  on  the  Conti- 
nent by  Weber,  but  was  previously  known  and  mentioned 
by  Lagueriniere,  Brognier,  and  Hurtrel  d'Arboval. 

When  the  grooving  is  in  a  horizontal  direction,  a  single 
incision  is  sufficient.  This  is  made  f  inch  below  the 
coronary  margin  of  the  wall,  and  parallel  with  it,  extend- 
ing from  the  point  of  the  heel  for  2  or  3  inches  in  a  forward 
direction.  As  in  the  previous  method,  a  bar  shoe  is  applied, 
and  the  animal  daily  exercised.  Thus  separated  from  the 
fixed  and  contracted  portion  of  the  wall  below,  the  more 
clastic  coronet  under  pressure  of  the  body-weight  com- 
mences to  bulge.  The  bulging  is  of  such  an  extent  as  to 
cause  the  new  growing  hoof  from  the  top  to  considerably 
overhang  the  contracted  portion  below,  and  cure  of  the 
condition  results  from  the  newly-expanded  wall  above 
growing  down  in  a  normal  direction. 

This  consideration  of  contracted  heels  may  be  concluded 
by  drawing  attention  to  the  advisability  of  always  main- 
*  W.  S.  Adams,  M.R.C.V.S.,  Veterinary  Journal,  vol.  xxx.,  p.  19. 


140        DISEASES  OF  THE  HORSE'S  FOOT 

taining  the  horn  of  the  wall  in  as  soft  and  supple  a  con- 
dition as  is  natural  by  the  application  of  suitable  hoof 
dressings. 

A  useful  one  for  the  purpose  is  that  made  with  lard, 
to  which  has  been  added  a  small  quantity  of  wax  or 
turpentine. 

Especially  should  a  dressing  like  this  be  used  when  the 
hoof  is  inclined  to  be  hard  and  brittle,  and  where  tendency 
to  contraction  has  already  been  noticed- 

The  application  of  a  hoof  ointment  is  also  particularly 
indicated  where  the  foot  is  much  exposed  to  dampness, 
where  the  animal  is  compelled  to  stand  for  long  periods 
upon  a  dry  bedding,  or  where  the  bedding  is  of  a  substance 
calculated  to  have  a  deleterious  effect  upon  the  horn. 

This,  in  conjunction  with  correct  shoeing,  will  probably 
serve  to  avoid  the  necessity  for  more  drastic  measures  at  a 
later  time. 

(b)  Local  or  Coronary  Contraction. 

Definition. — Contraction  at  the  heels,  confined  to  the 
horn  immediately  succeeding  that  occupied  by  the  coronary 
cushion.  Really,  the  condition  is  but  a  somewhat  arbitrary 
subdivision  of  contracted  hoof,  as  we  have  just  described  it 
in  general.  For  that  reason  we  shall  give  it  but  very  brief 
mention. 

Symptoms. — In  this  case  the  horn  of  the  heels,  instead  of 
running  down  in  a  straight  line  from  the  coronary  margin 
to  the  bearing  surface  of  the  wall,  presents  a  more  or  less 
distinct  concavity  (See  Fig.  79,  a,  a). 

As  is  the  case  with  contraction  considered  as  a  whole, 
this  deformity  may  affect  one  or  both  heels ;  and  during  its 
first  appearance,  which  is  after  the  first  few  shoeings,  the 
animal  may  go  distinctly  lame. 

Causes. — Coronary  contraction  may  occur  in  hoofs  of 
normal  shape  immediately  shoeing  is  commenced,  and  frog 
pressure  with  the  ground  removed.  It  is  far  more  likely  to 
ensue,  however,  if  the  hoof  is  flat,  with  the  heels  low,  and 
the   wall   sloping.     And  with   those   predisposing   circum- 


FAULTY   CONFORMATION 


141 


stances  it  is  that  the  horse  goes  lame,  and  not  with  the 
hoof  of  normal  shape- 
Seeing,  then,  that  this  condition  is  largely  dependent 
upon  the  shape  of  the  foot,  we  may,  to  some  extent,  regard 
it  as  hereditary.  Seeing  further,  however,  that  it  only 
appears  when  shoeing  is  commenced,  we  may  in  a  greater 
degree  also  regard  it  as  acquired.  The  lesson,  therefore, 
that  this  and  other  forms  of  contraction  should  teach  us  is 
the  carefulness  with  which   the   shoeing  should  be  super- 


Fig.    79. — Hoof  with   Local   or   Coronary    Contractions    (as   in- 
dicated  at   the   Points   a,   a). 

intended  in  a  large  stud,  or  in  any  case  where  the  animal 
is  of  more  than  ordinary  value. 

The  explanation  of  the  restricted  nature  of  this  form  of 
contraction  is  simple  enough.  We  have  only  to  refer  to 
the  lessons  taught  by  the  experiments  of  Lungwitz,  de- 
scribed in  Chapter  III.,  and  the  condition  almost  explains 
itself.  We  remember  that,  briefly,  the  coronary  margin  of 
the  wall  resembles  a  closed  elastic  ring,  which  yields  and 
expands    to    local    pressure,    no    matter    how    slight.      We 


142         DISEASES  OF  THE  HORSE'S  FOOT 

remember  also  that  removal  of  the  counter-pressure  of  the 
frog  with  the  ground  tended  to  contraction  of  the  wall's 
solar  edge  when  weight  was  applied.  Connect  these  two 
facts  with  the  experience  that  this  form  of  contraction  more 
often  than  not  occurs  in  hoofs  with  sloping  heels,  and  we 
arrive  at  the  following: 

1.  The  excessive  slope  of  the  heels  tends  to  throw  a  more 
than  usual  part  of  the  body-weight  upon  the  posterior 
portion  of  the  coronary  margin  of  the  wall,  with  a  conse- 
quent expansion  of  that  part  of  the  coronary  margin 
implicated. 

2.  That  the  shoeing,  in  removing  the  counter-pressure 
of  the  frog  with  the  ground,  is  at  the  same  time  tending  to 
bring  about  contraction  of  the  lower  portions  of  the  wall  at 
the  heels  and  quarters. 

3.  That  this  tendency  to  contraction  will  at  first  appear 
in  the  thinner  portion  of  the  area  of  wall  named — namely, 
in  that  immediately  below  the  bulging  coronary  margin. 

We  thus  get  the  appearance  depicted  in  Fig.  79 — a  coiv 
traction  (a,  a)  of  the  heels  in  the  horn  below  the  coronary 
margin,  with  the  coronary  margin  itself  bulging  above,  and 
a  hoof  of  apparently  normal  width  below- 

We  say  '  apparently '  with  a  purpose,  for,  as  actual 
measurements  will  show,  the  wall  near  the  solar  edge  is 
really  contracting,  for  reasons  which  we  have  just  described 
connected  with  shoeing.  Its  '  appearance  '  of  normal  width 
is  accounted  for  thus :  The  contraction  at  a,  a  is  caused  by 
the  dragging  inwards  of  the  coronary  cushion  brought  about 
by  the  sinking  downwards  of  the  plantar  cushion,  with 
which  body  it  will  be  remembered  the  coronary  cushion  is 
continuous.  With  the  constant  dragging  in  and  down  of 
the  coronary  cushion  there  is  given  to  the  horn-secreting 
papillae,  studding  both  the  lower  third  of  its  outer  face  and 
its  lowermost  surface,  a  distinct  '  cant '  outwards.  Below 
the  lowermost  limit  of  the  coronary  cushion,  then,  by  reason 
of  the  cant  outwards  of  the  coronary  papilse  in  the 
situations  mentioned,  the  horn  of  the  wall  takes  a  more 
outward   direction   than   normal,   a   fact   which   lessens   in 


FAULTY  COX  FORMATION  143 

effect  the  contraction  as  a  whole  really  going  on.     It  is 
interesting,  too,  to  note  that  by  this  outward  cant  of  the 
wall  below,  and  the  bulging  of  the  coronary  margin  above 
it,  the  contraction  (a,  a)  is  heightened  in  effect,  and  cause 
to  appear  greater  than  really  it  is. 

From  what  we  have  said  it  follows  that  contraction  of 
the  heels,  excepting  the  extreme  coronary  margin,  is 
existent  generally,  and  not  confined  solely  to  a,  a. 

We  have,  then,  in  this  condition,  as  we  indicated  at  the 
commencement,  but  a  phase  in  the  evolution  of  ordinary 
contracted  heels,  for,  with  the  progress  of  the  contraction 
already  existing  at  a,  a,  and  below  those  points,  it  is  only 
fair  to  assume  that  with  it  falling  in  of  the  at  present 
bulging  coronary  margin  must  sooner  or  later  occur,  that, 
though  expanded  when  compared  with  the  wall  below  it. 
it  will  be  really  contracted  as  compared  with  what  it  was 
once  in  that  same  foot. 

We  may  therefore  conclude  this  section  by  remarking 
that  factors  tending  to  contraction  of  the  heels  in  general 
are  equally  potent  in  the  causation  of  contracted  coronet 
alone. 

Treatment. — Exactly  that  described  for  contracted  heels. 
I  "bearing  in  mind  that  contracted  coronary  margin  is  but 
the  onset  of  contracted  heels,  and  that  its  first  exciting 
cause  is  that  of  removal  of  the  ground-pressure  upon  the 
frog,  the  most  careful  attention  must  be  paid  to  the  shoeing. 
The  use  of  bar  shoes,  ordinary  frog  pads,  or  heelless  shoes 
and  bar  pads,  are  especially  indicated,  together  with 
abundant  exercise.  By  these  means  the  normal  move- 
ments of  expansion  will  be  brought  into  play,  and  the 
condition  quickly  remedied. 

C.   FLAT  FOOT. 

Definition. — By  this  term  is  indicated  a  condition  of  the 
foot  where  the  natural  concavity  of  the  sole  is  absent. 

Symptoms — In  the  flat-foot  the  inferior  edge  of  the  wall, 
the   sole,   and  the   frog,  all  lie  more  or  less   in  the  same 


144 


DISEASES  OF  THE  HORSE'S  FOOT 


plane.  It  is  a  condition  observed  far  more  frequently  in 
fore  than  in  hind  limbs,  and  is  seen  in  connection  with 
low  heels,  more  or  less  obliquity  of  the  wall,  and  a  tendency 
to  contraction.  The  action  of  the  animal  with  flat  feet  is 
heavy,  a  result  partly  of  the  build  of  the  foot,  and  partly 
of  the  tenderness  that  soon  comes  on  through  the  liability 
of  the  sole  to  constant  bruising. 


This  figure  represents  the  lower  surface  of  a  typical  flat-foot. 
It  illustrates,  too,  the  commencement  of  a  condition  we  re- 
ferred to  in  Section  B  of  this  chapter — namely,  the  com- 
pression of  the  frog  by  the  ingrowing  heels  (b)  and  bars  (a). 


Causes. — Flat-foot  is  undoubtedly  a  congenital  defect., 
and  is  seen  commonly  in  horses  of  a  heavy,  lymphatic  type, 
and  especially  in  those  bred  and  reared  on  low,  marshy 
lands.  It  is  thus  a  common  condition  of  the  forefeet  of 
the  Lincolnshire  shire. 

As  might  be  expected,  a  foot  of  this  description  is  far 
more  prone  to  suffer  from  the  effects  of  shoeing  than  is  the 
foot  of  normal  shape,  and  regarded  in  this  light  shoeing 
may  be  looked  upon  as,  if  not  an  actual  cause,  certainly  a 
means  of  aggravating  the  condition.  Directly  the  shoe — 
or    at    any    rate    the    ordinary    shoe — is  applied,  mischief 


FAULTY  CONFORMATION  145 

commences.  The  frog  is  raised  from  the  ground,  and  the 
whole  of  the  weight  thrown  on  to  the  wall.  The  heels, 
already  weak  and  inclined  to  turn  in,  are  unable  to  bear 
the  strain.  They  turn  in,  and  contraction  commences. 
This  '  turning  in  '  of  the  heels  is  favoured  by  the  undue 
obliquity  of  the  wall.  At  the  same  time,  the  sole  being 
archless,  a  certain  amount  of  elasticity  is  lost.  The  weight 
is  thrown  more  on  to  the  heels,  and  the  os  pedis  slightly 
descends,  rendering  the  flatness  of  the  sole  even  more 
marked  than  before.  With  the  loss  of  elasticity  of  the  sole 
concussion  makes  itself  more  felt.  The  animal  is  easily 
lamed,  bruised  sole  becomes  frequent,  and  corns  sooner  or 
iater  make  their  appearance- 

Treatment. — Flat-foot  is  incurable.  All  that  can  be  done 
is  to  pay  careful  attention  to  the  shoeing,  and  so  prevent 
the  condition  from  being  aggravated.  In  trimming  the 
foot  the  sole  should  not  be  touched;  the  frog,  too,  should 
be  left  alone,  and  the  wall  pared  only  so  far  as  regards 
broken  and  jagged  pieces. 

The  most  suitable  shoe  is  one  moderately  seated.  If  the 
seating  is  excessive,  and  bearing  allowed  only  on  the  wall, 
there  is  a  tendency  for  the  wall  to  be  pushed  outwards,  and 
for  the  sole  to  drop  still  further.  On  the  other  hand,  if 
the  seating  is  insufficient,  or  the  web  of  the  shoe  top  wide, 
and  too  great  a  bearing  thus  given  to  the  sole,  then  we  get, 
first,  an  undue  pressure  upon  the  last-named  portion  of 
the  foot  a  bruise,  and,  finally,  lameness.  The  correct 
bearing  should  take  in  the  whole  of  the  wall  and  the  whole 
of  the  white  line,  and  should  just  impinge  upon  the  sole. 
Above  all,  the  heels  of  the  shoe  should  be  of  full  length, 
otherwise,  if  the  shoe  is  worn  just  a  little  too  long,  its 
heels  are  carried  under  the  sole  of  the  foot,  and  by  pressure 
there  produce  a  corn. 

If,  with  these  precautions  in  shoeing  flat-foot,  tenderness 
still  persists,  a  sole  of  leather  or  gutta-percha  must  be  used 
with  the  shoe. 


146        DISEASES  OF  THE  HORSE'S  FOOT 

D.  PUMICED-FOOT,  DEOPPED  SOLE,  OE  CONVEX  SOLE. 

Definition. — This  term  is  applied  to  the  foot  when  the 
shape  of  the  sole  is  comparable  to  the  bottom  of  a  saucer. 
When  least  marked  it  is  really  an  aggravated  form  of 
flat-foot. 

Symptoms. — In  pumiced-foot  the  sole  projects  beyond  the 
level  of  the  wall-  The  obliquity  of  the  latter  is  more  marked 
than  in  the  previous  condition,  and  progression,  to  a  large 
extent,  takes  place  upon  the  heels.  In  addition  to  its 
deformity,  the  horn  is  greatly  altered  in  quality,  and,  as 
the  name  'pumice5  indicates,  is  more  or  less  porous  in 
appearance,  bulging,  and  brittle. 

Causes. — -As  a  general  rule,  it  may  be  taken  that  pumiced^ 
foot  is  a  sequel  of  previous  disease,  although  in  its  least 
pronounced  form  it  may  occur  as  the  result  of  accidental 
or  other  causes,  such  as  those  described  in  the  causation 
of  flat-foot. 

Occurring  in  its  most  marked  form,  there  is  no  gain- 
saying the  fact  that  pumiced-foot  is  a  sequel  of  either  acute 
or  subacute  laminitis.  As  we  shall  see  when  we  come  to 
study  that  disease,  the  dropping  of  the  sole  is  brought 
about  by  distinct  and  easily-understood  morbid  processes 
affecting  the  sensitive  structures.  Briefly,  these  morbid 
processes  in  laminitis  may  be  described  thus :  The  accumu- 
lated inflammatory  exudate,  and  in  some  cases  pus,  weakens 
and  destroys  the  union  between  the  sensitive  and  insen- 
sitive laminae.  This  separation,  for  reasons  afterwards  to 
be  explained,  is  greatest  in  the  region  of  the  toe.  The 
os  pedis,  loosened  from  its  intimate  attachment  with  the 
horny  box,  is  dropped  upon  the  sole,  and  the  sole,  unable 
to  bear  the  weight,  commences  to  bulge  below. 

The  altered  character  of  the  horn  is  accounted  for  by 
the  inflammatory  changes  in  the  sensitive  laminae  and  the 
papillae  of  the  keratogenous  membrane  generally,  for  it 
follows  as  a  matter  of  course  that  these  tissues,  themselves 
in  a  diseased  condition,  must  naturally  produce  a  horn  of 
a  greatly  altered  and  inferior  quality. 


FAULTY  CONFORMATION.  147 

When  following  the  subacute  form  of  laminitis,  the 
changes  characterizing  pumiced-foot  are  slow  in  making 
their  appearance.  The  animal  at  first  goes  short,  and  the 
lameness  thus  indicated  gradually  becomes  more  severe, 
until  the  animal  is  no  longer  able  to  work.  The  feet 
become  hot  and  dry,  the  hoof  loses  its  circular  form,  and 
the  growth  of  horn  at  the  heels  becomes  excessive.  At 
this  stage  the  appearance  of  bulging  at  the  sole  begins  to 
make  itself  seen.  Later,  the  outer  surface  of  the  wall 
becomes  '  ringed  '  or  '  ribbed,'  the  rings  being  somewhat 
closely   approximated    in   the   region   of   the   toe,   and   the 


Fig.  81. — Hoof  with  the  Ribs  or  Rings  caused  by  Chronic 
Laminitis. 

distance  between  them  gradually  widening  towards  the  heels. 
The  wall  too,  especially  in  the  region  of  the  toe,  instead  of 
running  in  a  straight  line  from  the  coronary  margin  to  the 
shoe,  becomes  concave.  It  is  this  change,  together  with 
the  appearance  of  the  rings,  that  indicates  the  loosening 
of  the  attachment  of  the  os  pedis  to  the  wall,  and  its  after- 
wards backward  and  downward  direction  (see  Fig.  124). 

As  a  sequel  of  acute  laminitis,  these  changes  make  their 
appearance  with  more  or  less  suddenness,  and  are  generally 
complicated  in  that  they  owe  their  occurrence  to  the  forma- 
tion of  pus  within  the  horny  box. 

Treatment. — Pumiced-foot  is  always  a  serious  condition. 
The  animal  is  useless  for  work  upon  hard  roads  or  town 


148        DISEASES  OF  THE  HORSE'S  FOOT 

pavings,  and  is  of  only  limited  utility  for  slow  work  upon 
soft  lands.  The  more  serious  form,  that  following  acute 
Jaminitis,  and  complicated  by  the  presence  of  pus,  we  may 
regard  as  beyond  hope  of  treatment. 

With  the  more  simple  form  of  the  condition,  we  may  do 
much  to  render  greater  the  animal's  usefulness.  The  same 
principles  as  were  applied  to  the  shoeing  of  flat  feet  will 
have  to  be  observed  here.  Trimming  or  paring  of  any 
kind,  save  '  straightening  up  '  of  the  wall,  must  be  severely 
discountenanced.  A  broad-webbed  shoe,  one  that  will  give 
a  certain  amount  of  cover  to  the  sole,  is  indicated.  As  in 
the  treatment  of  flat-foot,  however,  direct  pressure  upon 
the  sole  must  be  avoided,  and  the  shoe  '  seated.'  The 
'  seating,'  however,  should  not  commence  from  the  absolute 
outer  margin  of  the  shoe's  upper  surface-  A  flat  bearing 
should  be  given  to  the  wall  and  the  white  line,  and  the 
seating  commenced  at  the  sole. 

We  have  already  remarked  on  the  increased  growth  of 
horn  at  the  heels.  It  is  in  this  position,  then,  that  will  be 
found  the  greatest  bearing  surface  for  the  shoe,  and  it  is 
wise,  in  this  case,  to  have  the  heels  of  the  shoe  kept  flat. 
In  other  words,  the  '  seating '  is  not  to  be  continued  to  the 
hindermost  portion  of  the  branches  of  the  shoe.  By  this 
means  there  may  be  obtained  at  each  heel  a  good  solid 
bearing  of  from  2  to  3  inches,  which  would  otherwise  be  lost. 

Where  the  accompanying  condition  of  the  horn  is  bad 
enough  to  indicate  it,  a  leather  sole  should  be  used,  beneath 
which  has  been  packed  a  compress  of  tow  and  grease, 
rendered  more  or  less  antiseptic  by  being  mixed  with  tar. 

Where  the  sole  is  exceedingly  thin,  and  inclined  to  be 
easily  wounded,  and  where  the  hoof,  by  its  brittleness,  has 
become  chipped  and  ragged  at  the  lower  margin  of  the 
wall,  it  may  perhaps  be  more  advantageous  to  use,  in  place 
of  the  compress  of  tow,  the  huflederkitt  of  Rotten.  This 
is  a  leather-like,  dark  brown  paste.  When  warmed  in  hot 
water,  or  by  itself,  it  becomes  soft  and  plastic,  and  may 
readily  be  pressed  to  the  lower  surface  of  the  foot,  so  as  to 
fill   in   all   little   cracks   and   irregularities,   and    furnish   a 


FAULTY    CONFORMATION  149 

complete  covering  to  the  sole  and  frog,  and  to  the  bearing 
surface  of  the  wall.  When  cold  it  hardens,  without  losing 
the  shape  given  to  it,  into  a  hard,  leather-like  substance. 

Treated  in  this  way,  the  animal  with  pumiced  feet  may 
yet  be  capable  of  earning  his  living  at  light  labour  or  upon 
a  farm. 

E.    'EIXGED'  OR  'RIBBED'  HOOE. 

Definition. — A  condition  of  the  hoof  in  which  the  wall  is 
marked  by  a  series  of  well-defined  ridges  in  the  horn,  each 
ridge   running  parallel   with   the   coronary   margin.      They 


Fig.  82. — Hoof  showing  the  Rings  in  the  Horn  brought  about 
by  Physiological  Causes. 

are  known  commonly  as  '  grass  rings,'  and  may  be  easily 
distinguished  from  the  more  grave  condition  we  have 
alluded  to  as  following  laminitis,  by  the  mere  fact  that 
they  do  not,  as  do  the  laminitic  rings,  approximate  each 
ether  in  the  region  of  the  toe,  but  that  they  run  round  the 
foot,  as  we  have  already  said,  parallel  with  each  other. 

Causes — This  condition  is  purely  a  physiological,  and 
not  a  pathological  one,  and  the  words  of  its  more  common 
name,  '  grass  rings,'  sufficiently  indicate  one  of  the  most 
common  causes.  Anything  tending  to  an  alternate  increase 
and  decrease  in  the  secretion  of  horn  from  the  coronet  will 


l.SO         DISEASES  OF  THE  HORSE'S  FOOT 

bring  it  about.  Thus,  in  an  animal  at  grass,  with,  according 
to  the  weather  conditions,  an  alternate  moistness  and 
dryness  of  the  pasture,  with  its  consequent  influence  on 
the  horn  secretion,  these  rings  nearly  always  appear.  The 
effects  of  repeated  blisters  to  the  coronet  make  themselves 
apparent  in  the  same  way,  and  testify  to  the  efficacy  of 
blisters  in  this  region  in  any  case  where  an  increased 
growth  of  horn  is  deemed  necessary.  From  this  it  is  clear 
that  the  condition  depends  primarily  upon  the  amount  and 
condition  of  the  blood  supplied  to  the  coronary  cushion. 
Thus,  fluctuations  in  temperature  during  a  long-continued 
fever,  or  the  effects  of  alternate  heat  and  cold,  or  of  healthy 
exercise  alternated  with  comparative  idleness,  will  each  rib 
the  foot  in  much  the  same  manner. 

Treatment. — The  condition  is  so  simple  that  we  may 
almost  regard  it  as  normal.  Consequently,  treatment  of 
any  kind  is  superfluous.  Where  constitutional  disturbance 
is  exerting  an  influence  upon  either  the  quality  or  quantity 
of  the  blood  directed  to  the  part,  then,  of  course,  attention 
must  be  paid  to  the  disease  from  which  it  is  arising. 

F.    THE  HOOF  WITH  BAD  HOEN. 
(a)   The  Brittle  Hoof. 

Definition. — As  the  name  indicates,  we  have  in  this  con- 
dition an  abnormally  dry  state  of  the  horn. 

Symptoms. — These  are  obvious-  The  horn  is  hard,  and 
when  cut  by  the  farrier's  tools  gives  the  impression  of 
being  baked  hard  and  stony,  the  natural  polish  of  the 
external  layer  is  wanting,  and  there  is  present,  usually,  a 
tendency  to  contracted  heels.  With  the  dryness  is  a 
liability  to  fracture,  especially  at  points  where  the  shoe  is 
attached  by  the  nails.  As  a  consequence,  the  shoes  are 
easily  cast,  leading  to  splits  in  the  direction  of  the  horn 
fibres.  These  run  dangerously  near  the  sensitive  struc- 
tures, giving  rise  in  many  cases  to  lameness.  Even  where 
pronounced   lameness   is   absent   the   action   becomes   short 


FAULTY   CONFORMATION  151 

and  '  groggy,'  and  the  utmost  care  is  required  in  the  shoeing 
to  keep  the  animal  at  work. 

Causes. — To  a  very  great  extent  the  condition  is  heredi- 
tary, and  is  observed  frequently  in  animals  of  the  short, 
'  cobby  '  type.  In  ponies  bred  in  the  Welsh  and  New- 
Forest  droves  the  condition  is  not  uncommon,  especially 
iii  the  smaller  animals.  Animals  who  have  had  their  feet 
much  in  water — as,  for  instance,  those  bred  and  reared  on 
marshy  soils — and  afterwards  transferred  to  the  constant 
dryness  of  stable  bedding,  are  also  particularly  liable  to 
this  condition.  It  is  noticed,  too,  following  the  excessive 
use  of  unsuitable  hoof-dressings,  more  especially  in  cases 
where  coat  after  coat  of  the  dressing  is  applied  without 
occasionally  removing  the  previous  applications. 

Treatment. — As  a  prophylactic,  a  good  hoof -dressing  is 
indicated.  It  should  not  consist  solely  of  grease,  but  should 
have  mixed  with  it  either  wax,  turpentine,  or  tar. 

Above  all,  careful  shoeing  should  be  insisted  on,  and  the 
owner  of  an  animal  with  feet  such  as  these  will  be  well 
advised  if  he  is  recommended  to  have  the  shoeing  super- 
intended by  one  well  competent  to  direct  it  rightly.  The 
foot  should  be  trimmed  but  lightly,  always  remembering 
that  in  a  foot  of  this  description  the  horn,  in  addition  to 
being  brittle,  is  generally  abnormally  thin.  Jagged  or 
partly  broken  pieces  should  be  removed,  and  the  bearing 
surface  rendered  as  level  as  possible.  The  foot  should  be 
carefully  examined  before  punching  the  nail-holes  in  the 
shoe,  and  the  nail-holes  afterwards  placed  so  as  to  come 
opposite  the  soundest  portions  of  horn.  The  nails  them- 
selves should  be  as  thin  as  is  consistent  with  durability, 
and  should  be  driven  as  high  up  as  possible. 

On  the  least  sign  of  undue  wear  the  shoes  should  be  re- 
moved, never,  as  is  too  often  done,  allowing  them  to  remain 
on  so  long  that  a  portion  breaks  away.  If,  with  the  laud- 
able idea  of  not  interfering"  with  the  horn  more  than  is 
possible,  this  is  practised,  the  portion  of  the  shoe  breaking 
off  is  bound  to  tear  away  with  it  more  or  less  of  the  brittle 
horn  to  which  it  is  attached. 


152        DISEASES  OF  THE  HORSE'S  FOOT 

Where  the  breaks  in  the  horn  are  so  large  as  to  prevent 
a  level  bearing  for  the  shoe  being  obtained,  the  interstices 
should  be  filled  up  with  one  or  other  of  the  preparations 
made  for  this  purpose.  One  of  the  most  suitable  is  that 
discovered  by  M.  Defay.  By  its  means  sand-cracks  or 
other  fractures  of  the  horn  may  be  durably  cemeted  up. 

'  Even  pieces  of  iron  may  be  securely  joined  together  by 
its  means.  The  only  precaution  for  its  successful  applica- 
tion is  the  careful  removal  of  all  grease  by  spirits  of  sal- 
ammoniac,  sulphide  of  carbon,  or  ether.  M.  Defay  makes 
no  secret  of  its  composition,  which  is  as  follows :  Take 
1  part  of  coarsely-powdered  gum-ammoniac,  and  2  parts  of 
gutta-percha,  in  pieces  the  size  of  a  hazel-nut.  Put  them  in 
a  tin-lined  vessel  over  a  slow  fire,  and  stir  constantly  until 
thoroughly  mixed.  Before  the  thick,  resinous  mass  gets 
cold  mould  it  into  sticks  like  sealing-wax.  The  cement 
will  keep  for  years,  and  when  required  for  use  it  is  only 
necessary  to  cut  off  a  sufficient  quantity,  and  remelt  it 
immediately  before  application.  We  have  frequently  used 
this  cement  for  the  repair  of  seriously  broken  hoofs.  It  is 
so  tenacious  that  it  will  retain  the  nails  by  which  the  shoe 
is  attached  without  tearing  away  from  the  hoof.'* 

Failing  this,  the  bearing  surface  may  be  made  level,  and 
fractures  repaired  by  using  the  huflederkitt  described  in 
the  treatment  of  pumiced  sole. 

(b)  The  Spongy  Hoof. 

Definition. — This  is  the  opposite  condition  to  the  one  we 
have  just  described,  and  is  characterized  by  the  soft  and 
non-resistant  qualities  of  the  horn. 

Symptoms. — Spongy  hoof  is  quite  common  in  animals 
that  have  large,  flat,  and  spreading  feet — in  fact,  the  two 
appear  to  run  very  much  together.  It  is  a  common  defect 
in  animals  reared  in  marshy  districts,  and  of  a  heavy, 
lymphatic  type.  The  Lincolnshire  Shire,  for  instance,  has 
often  feet  of   this   description,   and,   the   causative   factors 

*  Veterinary  Journal,  vol.  iii.,  p.  71. 


FAULTY  CONFORMATION  153 

being  in  this  case  long-continued,  render  the  feet  extremely 
predisposed  to  canker.  The  horn  is  distinctly  soft  to  the 
knife,  and  has  an  appearance  more  or  less  greasy.  Animals 
with  spongy  feet  are  unfit  for  long  journeys  on  hard  roads. 
When  compelled  to  travel  thus,  the  feet  become  hot  and 
tender,  and  lameness  results.  A  mild  form  of  laminitis, 
extending  over  a  period  of  three  or  four  days,  often  follows 
on  this  enforced  travelling  on  a  hard  road,  more  especially 
in  cases  where  the  animal  is  '  heavy  topped,'  and  the  usual 
food  of  a  highly  stimulating  nature.  In  fact,  it  has  been  the 
author's  experience  to  meet  with  this  condition  several  times 
in  the  case  of  shire  stallions  doing  a  long  walk  daily  upon 
hard  roads,  with  the  weather  hot  and  dry. 

Treatment. — When  a  horse  with  spongy  feet  is  shod  for 
the  first  time,  care  must  be  taken  to  avoid  excessive  paring 
of  the  sole,  for  already  the  natural  wear  of  the  foot  has 
been  sufficient  to  keep  the  soft  horn  m  a  state  of  thinness. 
For  the  same  reason  hot  fitting  of  the  shoe  must  not  be 
indulged  in  for  too  long  a  time.  That  common  malprac- 
tice of  the  forge,  '  opening  up  the  heels,'  must,  in  this  case, 
be  especially  guarded  against,  or  the  excessive  paring  of  the 
frog  and  partial  removal  of  the  bars  that  this  operation 
consists  in  will  lay  the  foot  open  to  risk  of  contraction. 
To  begin  with,  the  heels  are  naturally  weak,  and,  once  the 
bars  are  removed,  there  is  nothing  to  prevent  them  rapidly 
caving  in  towards  the  frog.  Even  when  carefully  shod,  a 
foot  of  this  class  is  readily  prone  to  contract  directly  the 
animal  is  brought  into  the  stable,  and  the  horn  commences 
to  dry  to  excess.  An  ordinary  light  shoe  should  be  used, 
and  the  nails  should  be  light  and  thin.  They  should  be 
driven  carefully  home,  and  the  '  clinching '  made  as  tight 
and  secure  as  possible. 

G.    CLUB-FOOT. 

Definition. — Under  this  name  we  indicate  all  cases  in 
which  the  horn  of  the  wall  become  straightened  from  above 
to  below.  It  will,  therefore,  include  all  conformations 
varying  from  the  so-called  '  upright  hoof,'  in  which  the  toe 


154        DISEASES  OF  THE  HORSE'S  FOOT 

forms  an  angle  of  more  than  60  degrees  with  the  ground,  to 
the  badly  '  clubbed  '  foot,  in  which  the  horn  at  the  toe  forms 
a  right  angle  with  the  ground,  or  is  even  directed  obliquely 
backwards  and  downwards,  so  that  the  coronary  margin 
overhangs  the  solar  edge  of  the  wall. 

Symptoms. — Even  in  its  least  pronounced  form  the  con- 
dition is  apparent  at  a  glance,  the  alteration  in  the  angle 
formed  by  the  hoof  with  the  ground  striking  the  eye  at 
once,  and  the  heels,  as  compared  with  the  toe,  appearing 


Fig.  83.— The  Club-foot. 

much  too  high.  When  the  condition  is  slight,  the  wall  of 
the  toe  is  about  as  high  as  that  of  the  heels,  while  in 
the  most  marked  form  the  toe  and  the  heels  may  in  height 
be  nearly  equal  (see  Fig.  83).  When  congenital,  but  little 
interference  with  the  action  is  noticed.  Such  animals,  by 
reason  of  their  k  stiltiness,'  are  unfit  for  the  saddle,  but  at 
ordinary  work  will  perform  their  duties  equally  well  with 
the  animal  of  normal-shaped  feet.  When  acquired  as  the 
result  of  overwork,  of  contracted  tendons,  or  other  causes, 
however,  the  gait  becomes  stumbling  and  uncertain.     The 


FAULTY    CONFORMATION  155 

body-weight  is  transferred  from  the  heels  to  the  anterior 
parts  of  the  foot,  and  the  shoe  shows  undue  signs  of  wear 
at  the  toe. 

Causes. — Upright  hoof  is  undoubtedly  hereditary,  and  is 
even  seen  as  a  natural  conformation  in  the  feet  of  asses 
and  mules.  When  hereditary  in  the  horse,  however,  it  is 
certainly  a  defect,  and  is  associated  commonly  with  an 
upright  limb,  and  a  short,  upright  pastern  (see  Fig.  83). 

Among  other  causes,  we  may  enumerate  sprains  or 
wounds  of  the  flexor  tendons,  or  any  disease  of  the  limbs 
for  a  long  time  preventing  extension  of  the  fetlock-joint, 
such  as  sprains  or  injuries  of  the  posterior  ligaments  of  the 
limb,  splints  or  ringbones  so  placed  as  to  interfere  with  the 
movements  of  the  flexor  tendons,  or,  in  the  hind-limb, 
spavin,  keeping  for  some  months  the  fetlock  in  a  state  of 
flexion.  In  the  very  young  animal  the  condition  may  be 
induced  by  an  improper  paring  of  the  foot — cutting  away 
too  much  at  the  toe,  and  allowing  the  heels  to  remain. 

Treatment. — \\  hen  the  condition  is  congenital,  no  treat- 
ment at  all  is  indicated.  It  might,  in  fact,  be  said  that 
interference  would  tend  rather  to  minimize  than  enhance 
the  animal's  usefulness ;  for,  in  this  case,  the  club-shaped 
feet  are  in  all  probability  due  to  faulty  conformation  above. 
In  other  words,  the  upright  hoof  is  in  this  instance  but  a 
natural  result  of  the  animal's  build,  with  which  useful 
interference  is  impossible. 

Where  the  upright  hoof  is  a  consequence  of  excessive 
paring  of  the  toe,  or  insufficient  removal  of  the  heels,  the 
condition  may  be  remedied  by  directing  attention  to  those 
particulars,  and  preventing  their  continuance.  At  the  same 
time,  a  greater  obliquity  of  the  limb  axis  may  be  given  by 
the  use  of  a  suitable  shoe.  The  shoe  indicated  is  a  short 
one,  with  thin  heels  and  a  thick  toe.  In  some  cases  the 
abnormality  may  be  remedied  by  the  use  of  a  tip.  What- 
ever method  is  adopted,  care  must  be  taken  not  to  attempt 
too  positive  a  change  in  the  direction  of  the  limb  at  one 
operation.    The  process  must  be  gradual. 

In  cases  where  the  abnormality  has  been  brought  about 


156 


DISEASES  OF  THE  HORSE'S  FOOT 


by  wounds  to  the  flexor  tendons,  the  alteration  in  the 
direction  of  the  limb  is  often  so  great  as  to  produce 
'knuckling  over '  of  the  fetlock.  This,  to  a  very  great 
extent,  may  be  remedied  by  the  use  of  a  shoe  with  calkins 
?nd  an  extended  toe-piece  (see  Fig  84). 

With  this  shoe  a  certain  amount  of  forced  exercise  is 


Fig.  84.— The  Shoe  with  Extended  Toe-piece  and  High 
Calkins. 


advisable,  and  at  intervals  of  about  two  weeks  the  calkins 
should  be  somewhat  lowered,  until  the  heels  are  brought  as 
close  to  the  ground  as  is  possible.  In  giving  directions  for 
this  shoe  to  be  made  the  veterinary  surgeon  must,  when 
referring  to  the  length  of  the  toe-piece,  be  guided  entirely 
by  the  condition  of  the  case.  Ordinarily,  a  suitable  length 
is  from  3  to  4  inches.     It  is  necessary  also  to  warn  the 


FAULTY    CONFORMATION  157 

owner  that,  by  reason  of  the  length  projecting,  the  shoe  is 
liable  to  be  torn  off. 

Should  the  '  knuckling  over  '  have  become  complicated 
by  bony  deposits  round  the  seat  of  the  original  injury,  then 
a  favourable  modification  of  the  condition  is  not  so  likely 
to  result. 

The  benefit  to  be  derived  from  the  shoe  with  an  extended 
toe-piece  in  a  case  of  excessive  knuckling  is  admirably 
shown  in  a  brief  report  of  a  case,  under  the  title  of  '  Hooked 
Foot,'  in  vol.  xiv.  of  the  Veterinary  Record,  p.  716: 

'  An  eighteen  months'  old  filly  showed  a  deformity  of  the 
third  phalanx,  resulting  in  her  walking  with  the  front  face 
of  the  hoof  on  the  ground.  The  flexors  were  apparently  all 
right,  and  the  bending  back  seemed  to  be  due  to  contraction 
of  the  ligaments  of  the  joint  and  the  sheath  of  the 
perforans. 

'  On  the  ground  of  absence  of  contraction  of  the  flexors, 
or  atrophy  and  paralysis  of  the  extensors,  the  surgeon  con- 
sidered the  lesion  curable  by  simple  orthopaedic  measures. 
By  means  of  an  elongated  toe-piece  to  the  shoe  and  calkins, 
which  were  shortened  every  fifteen  days,  the  filly  was  com- 
pletely cured  in  seventy  days.' 

IT.   THE  CROOKED  FOOT. 

(a)  The  Foot  with  Unequal  Sides. 

Definition — The  foot  thus  affected  has  one  side  of  the 
wall  higher  than  the  other. 

Symptoms.-— -This  deformity  is  the  better  recognized  when 
the  foot  on  the  floor  is  viewed  from  behind.  In  addition  to 
the  difference  between  the  height  of  the  inner  and  outer  heel 
is  seen  at  once  a  deviation  in  the  normal  direction  of  the 
horn.  That  of  the  higher  side  is  distinctly  more  upright 
than  that  of  the  lower,  and  runs  from  above  downwards 
and  inwards  towards  the  axis  of  the  foot,  while  the  horn  of 
the  lower  side  maintains  its  normal  direction  of  downwards 
and  outwards. 


158        DISEASES  OF  THE  HORSE'S  FOOT 

From  what  we  have  said  before  on  contracted  foot,  this 
bending  in  of  the  wall  of  the  upright  side  will  at  once  be 
recognized  as  a  form  of  contraction.  It  is,  in  fact,  con- 
traction confined  to  one-half  of  the  foot  only,  and,  as  a 
result,  the  upright  side  of  the  crooked  foot  is  prone  to  the 
troubles  arising  from  that  condition.  Corns  are  frequent, 
and  atrophy  of  that  half  of  the  frog  on  the  affected  side 
supervenes.  With  the  inflammatory  changes  accompany- 
ing these  conditions  we  find  the  horn  of  the  affected  side 
deteriorating  in  quality.  It  becomes  dry  and  brittle,  and 
extremely  liable  to  sand-crack.  At  the  same  time,  thrush 
of  the  contracted  frog  begins  to  make  its  appearance. 

Causes. — More  often  than  not  this  condition  is  a  result 
of  the  conformation  of  the  limb.  According  as  the  build 
above  inclines  the  animal  to  '  turned  in  '  or  '  turned  out ' 
toes,  so  shall  we  have  feet  with  a  wall  crooked  inwards  or 
crooked  outwards;  and  it  may  be  mentioned  here  that  the 
evil  results  inflicted  on  the  foot  by  ill-shaped  limbs  above 
will  make  themselves  the  more  readily  noticed  when  the 
animal  comes  to  be  shod  for  any  length  of  time.  So  long 
as  a  natural  wear  of  the  foot  is  allowed,  so  long  does  it 
accommodate  itself  to  the  form  of  limb  above.  So  soon, 
however,  as  the  shoe  is  applied,  and  a  more  or  less  equal 
(and  in  this  case  harmful)  wear  by  that  means  insisted  on, 
so  soon  does  this  abnormal  change  in  the  height  and  direc- 
tion of  the  horn  fibres  begin  to  make  itself  seen- 

(While  arising  in  the  majority  of  instances  from  faulty 
conformation  of  the  limb,  crooked  feet  may  also  be  brought 
about  by  bad  shoeing,  or  by  unequal  paring  of  the  foot,  and, 
in  a  few  cases,  from  unequal  wear  of  the  foot  in  a  state  of 
nature. 

Treatment. — Although  it  may  be  taken  as  a  rule  that 
lowering  of  the  higher  wall,  even  if  persisted  in  at  every 
shoeing,  will  do  nothing  towards  remedying  the  primary 
cause  (viz.,  the  evil  conformation  of  the  limb),  yet  it  will 
serve  to  keep  the  condition  within  reasonable  limits.  In 
this  case,  while  removing  so  much  of  the  wall  as  is  deemed 
necessary,  care  must  be  taken  to  leave  uncut  the  sole  and 


FAULTY   CONFORMATION  159 

the  bar.  Leaving  these  intact  gives  us  two  natural  and 
very  potent  protections  against  the  contraction  already 
mentioned  as  impending. 

Where,  by  reason  of  the  thinness  of  the  horn  or  other 
causes,  sufficient  paring  to  equalize  the  tread  cannot  be 
practised,  then  the  same  end  may  be  arrived  at  by  the  use 
of  special  shoes.  That  branch  of  the  shoe  applied  to  the 
half  of  the  foot  with  the  lower  wall  should  be  thickened 
from  above  downwards.  Or,  on  the  same  branch,  may  be 
turned  up  a  calkin  of  sufficient  height  for  the  purpose.  Of 
the  two  methods  the  first  is  preferable. 

In  any  case,  whether  depending  upon  paring,  or  upon 
the  use  of  a  special  shoe,  the  animal  should  be  sent  to  the 
forge  quite  often,  for  it  is  only  by  a  well-directed,  and 
therefore  constant,  application  of  the  principles  here  laid 
down  that  improvement  may  be  brought  about. 

When  marked  contraction  of  one-half  of  the  foot  is 
present,  it  will  be  best  treated  with  the  expanding  shoe  o. 
Hartmann,  already  described  in  the  section  of  this  chapter 
dealing  with  contracted  heels  (see  Fig.  76). 

{b)  The  Curved  Hoof. 

Definition. — The  hoof  with  the  wall  of  one  side  convex, 
and  that  of  the  opposite  side  concave.  Fig.  85,  showing 
(.he  foot  in  section  from  side  to  side,  gives  an  exact  idea  of 
this  malformation. 

Causes. — As  was  the  case  with  the  condition  previously 
described,  this  abnormality  finds  its  primary  cause  in  an 
unequal  distribution  of  weight  due  to  vice  of  conformation 
in  the  limb  above,  causing  one  side  of  the  hoof  to  be  higher 
than  the  other.  As  a  result  of  this,  the  wall  that  is  in- 
ordinately increasing  in  height  commences  to  bulge  out- 
wardly (Fig.  85,  a),  while  the  opposite  (Fig.  85,  b)  becomes 
concave. 

The  same  state  of  affairs  may  be  occasioned  in  the 
forge  by  leaving  one  side  of  the  foot  too  high,  and  subject- 
ing the  other  to  excessive  paring  for  several  consecutive 
shoeings. 


160 


DISEASES  OF  THE  HORSE'S  FOOT 


Treatment. — In  the  main  this  condition  may  he  regarded 
as  a  long-standing  and  aggravated  form  of  the  foot  with 
unequal  sides.  We  may  say  at  once,  therefore,  that  it  is 
not  so  easily  remedied  as  that  simpler  defect ;  that,  although 
identical  principles  will  be  followed  in  its  treatment,  cure 
must  be  a  matter  of  some  considerable  time. 


&  b 

Fig.  85.— Section  through  a  Crooked  Foot. 

a,  The   higher  and   convex   side  of  the   wall;    b,  the   lower  and 
concave  side  of  the  wall. 


Again,  we  must  look  to  successive  parings  of  the  wall  of 
the  higher  side  to  bring  about  a  gradual  return  to  the 
normal.  At  the  same  time,  the  tendency  to  contraction  of 
that  side  is  counteracted  by  shoeing  wide,  and,  if  necessary, 
giving  to  the  upper  surface  of  that  branch  of  the  shoe  what 
we  have  termed  elsewhere  a  '  revised  seating  ' — viz.,  an 
incline  of  its  upper  surface  from  within  outwards. 


CHAPTER  VII 

DISEASES  ARISING  FROM  FAULTY 
CONFORMATION 

A.    SAND-CRACK. 

Definition, — A  solution  of  continuity  of  the  horn  of  the 
foot,  occurring  usually  in  the  wall,  and  following  the  direc- 
tion of  the  horn  fibres. 

Classification. — It  is  usual  to  classify  sand-cracks  accord- 
ing to — 

(a)  Their  Position. — Toe-crack  when  occurring  in  the 
middle  line  of  the  horn  of  the  toe,  and  quarter-crack  when 
occurring  in  the  horn  of  the  quarters- 
Sand-crack  of  the  frog  and  sand-crack  of  the  sole  may 

also  each  be  met  with.  They  are,  however,  of  rare  occur- 
rence, and  are  seldom  serious  enough  to  merit  special 
attention.  !  J  J  I 

The  toe-crack  is  met  with  more  often  in  the  hind-foot 
than  in  the  fore,  while  the  quarter-crack  more  often  than 
not  makes  its  appearance  in  the  fore-foot,  and  is  there,  as 
a  rule,  confined  to  the  inner  side,  The  reasons  for  these 
positions  being  so  affected  we  shall  deal  with  when  treating 
of  the  causes  of  sand-crack  in  general.  It  is  interesting  to 
note  that  the  portions  of  wall  known  as  inside  and  outside 
toe  are  seldom  affected. 

(b)  Their  Length. — Complete  when  they  extend  from  the 
coronary  margin  of  the  wall  to  its  wearing  edge;  Incom- 
plete when  not  so  extensive. 

(c)  Their  Severity. — Simple  when  they  occur  in  the  horn 
only,  and  do  not  implicate  the  sensitive  structures  beneath ; 

161 


162         DISEASES  OF  THE  HORSE'S  FOOT 

Complicated  when  deep  enough  to  allow  of  laceration  and 
subsequent  inflammation  of  the  keratogenous  membrane. 
Such  complications  may  vary  from  a  simple  inflammation 
set  up  by  laceration  and  irritation  of  the  sensitive  structures 
by  particles  of  dirt  and  grit  that  have  gained  entrance 
through  the  crack,  to  other  and  more  serious  changes  in  the 
shape  of  the  formation  of  pus,  haemorrhage  from  the 
laminal  vessels,  caries  of  the  os  pedis,  or  the  development 
of  a  tumour-like  growth  of  horn  on  the  inner  surface  of  the 
wall  known  as  a  keraphyllocele. 

(d)  Their  Duration. — Recent  when  newly  formed;  old 
when  of  long  standing. 

(e)  Their  Starting-point. — This  last  distinction  we  make 
ourselves,  and,  referring  to  cracks  of  the  wall,  term  them 
high  when  commencing  from  the  coronary  margin,  low 
when  starting  from  the  bearing  surface. 

Causes. — We  have  already  classified  sand-crack  as  a 
disease  arising  from  faulty  conformation.  Thus,  in  just  so 
far  as  a  predisposing  build  of  body  may  be  handed  down 
from  parent  to  offspring,  we  may  regard  sand-crack  as 
hereditary-  If  we  do  so,  however,  we  must  afterwards 
make  up  our  minds  to  sharply  distinguish  between  the  sand- 
crack  plainly  brought  about  by  accidental  cause,  and  that 
occurring  as  a  result  of  hereditary  evil  conformation. 

With  regard  to  the  latter,  we  need  hardly  say  that  feet 
with  abnormally  brittle  horn  are  extremely  liable.  But 
with  this,  as  with  many  other  affections  of  the  feet,  we 
shall  find  it  necessary  to  consider  several  causes  acting  in 
cooperation.  In  this  case,  for  instance,  given  the  brittle 
horn,  it  becomes  necessary  to  further  look  for  exciting 
causes  of  its  fracture. 

We  will  take  conformation  first.  In  the  animal  with 
turned-out  toes  a  more  than  fair  share  of  the  body-weight 
is  imposed  on  the  horn  of  the  inner  quarter.  Here,  then, 
three  causes  exert  their  influence  together :  The  horn  is 
brittle;  the  wall  of  the  inner  quarter  is  thinner  than  that 
of  the  outer;  additional  weight  is  imposed  upon  it.  Frac- 
ture results. 


DISEASES  FROM  FAULTY  CONFORMATION  163 

Take,  again,  the  vice  of  contracted  heels.  Here,  in  the 
first  place,  we  have  a  variety  of  causes  tending  to  bring 
about  the  contraction.  With  the  contraction,  and  its  con- 
sequent pressure  upon  the  sensitive  structures  in  the  region 
of  the  quarters  and  the  frog,  has  arisen  a  low  type  of 
inflammation.  The  horn  of  the  part  has  become  dry  and 
brittle.  The  exciting  cause  of  its  fracture  is  found  in  an 
excessive  day's  work  upon  a  hard,  dry  road,  with,  perhaps, 
a  suddenly-imposed  improper  distribution  of  weight,  due  to 
treading  upon  a  loose  stone,  or  a  succession  of  such  evil 
transfers  of  weight  due  to  travelling  upon  a  road  that  is 
rough  in  its  whole  extent. 

In  their  turn,  too,  such  defects  of  the  feet  as  we  have 
mentioned  in  the  last  chapter — as,  for  example,  the  foot 
with  the  pumiced  horn,  the  foot  with  abnormally  upright 
heels,  or  that  which  is  upright  on  one  side  only,  or  crooked 
— each  offers  a  condition  which  is  predisposing  to  the  for- 
mation of  a  sand-crack.  In  each  case  it  wants  but  the  un- 
even distribution  of  the  body-weight,  which,  as  a  matter  of 
fact,  some  of  these  conditions  themselves  give,  to  bring 
about  a  fracture. 

Apart  from  the  predisposition  conferred  by  conforma- 
tion, must  be  remembered  the  simpler  predisposing  causes 
leading  to  brittleness  of  the  hoof-  We  refer  to  the  after- 
effects of  poulticing,  the  moving  from  pasture  to  stable,  the 
emigration  from  a  damp  to  a  dry  climate,  or  the  alternate 
changes  from  damp  to  dry  in  a  temperate  region.  Each 
may  have  a  deteriorating  influence  upon  the  horn,  render- 
ing it  liable  to  the  condition  we  are  describing.  Excessive 
dampness  alone,  especially  when  the  animal  is  called  upon 
to  labour  at  the  drawing  of  heavy  loads  upon  a  rough  road, 
is  not  infrequently  a  cause.  In  this  case  the  wet,  together 
with  the  constant  friction  of  the  sharp  materials  of  which 
the  road  is  made,  serves  to  destroy  the  varnish-like  periople. 
The  wet  gains  access  to  the  inner  structures  of  the  wall, 
the  agglutination  of  the  horn  fibres  is  weakened,  and  fissures 
begin  to  appear. 

Other   causes  of   sand-crack  are  purely  accidental.     An 


164        DISEASES  OF  THE  HORSE'S  FOOT 

animal  at  fast  work  over-reaches.  The  secretion  of  horn  at 
the  injured  coronet  is  inferfered  with,  a  diminished  supply 
at  an  isolated  spot  being  the  result.  From  this  point  grows 
down  a  fissure  in  the  wall. 

An  injury  of  the  same  character  may  also  be  sustained 
in  various  other  ways — treads  from  other  animals  when 
working  in  pairs,  accidental  wounding  with  the  stable-fork, 
blows  of  any  kind,  or  a  self-inflicted  tread  with  the  calkin 
of  an  opposite  foot — each  with  the  same  result. 

So  far  as  causation  is  concerned,  toe-crack  stands  in  a 
class  almost  by  itself.  It  is  met  with  nearly  always  in  a 
heavy  animal  in  the  hind-foot,  and  is  directly  attributable 
to  the  force  exerted  in  starting  a  heavy  load. 

Unskilful  shoeing  also  plays  a  part  in  the  causation  of 
sand-crack.  Removal  of  the  periople  by  excessive  rasping 
of  the  wall  is  most  certainly  a  predisposing  cause.  Cracks, 
or  their  starting-points,  may  also  be  caused  by  using  too 
wide  a  shoe,  or  by  the  use  of  nails  too  large  in  the  shank. 
Also,  they  may  arise  from  unskilful  fitting  of  the  toe-clip, 
especially  in  the  hind-foot  of  a  heavy  animal-  It  must  be 
admitted,  however,  that  the  part  shoeing  plays  in  the  causa- 
tion of  sand-crack  is  not  a  large  one ;  far  more  depends 
upon  the  state  of  the  horn  and  the  animal's  conformation 
than  upon  the  exciting  cause. 

So  far,  our  observations  on  the  causes  of  sand-crack  have 
referred  to  that  form  occurring  in  the  wall.  Sand-crack  of 
the  sole  or  frog  we  have  already  said  is  but  seldom  met 
with,  and  then  it  is  always  in  connection  with  some  excep- 
tionally deteriorated  quality  of  the  horn,  as  in  the  case  of 
badly  pumiced  feet,  or  occurs  as  a  result  of  direct  injury. 
Extensive  slit-like  cuts  in  this  region,  when  deep  enough 
to  lacerate  the  keratogenous  membrane,  are  sometimes 
followed  by  the  growth  of  a  fissure  in  the  horn,  and  what 
might  almost  be  termed  a  permanent  sand-crack  results. 
Such  cuts  may  be  occasioned  by  sharp  flints,  broken  glass, 
or  other  sharp  objects  picked  up  on  the  road,  or  may  result 
from  the  animal  treading  on  the  toe-clip  of  a  partially  cast 
shoe. 


DISEASES  FROM  FAULTY  CONFORMATION  165 

Symptoms. — In  every  case  the  fissure,  or  evidence  of  its 
commencement,  is  a  diagnostic  symptom.  It  is  well  to 
remember,  however,  that  this  may  be  easily  overlooked, 
especially  when  the  crack  is  one  commencing  at  the 
coronary  margin.  The  reason  is  this  :  Sand-cracks  in  this 
position  often  commence  in  the  wall  proper,  and  not  in  the 
periople.  They  may,  in  fact,  be  first  observed  as  a  fine 
separation  of  the  horn  fibres  immediately  beneath  the 
pcrioplic  covering.  A  crack  of  this  description  may  even 
show  haemorrhage,  and  have  been  in  existence  for  some 
time,  without  the  periople  itself  showing  any  lesion  what- 
ever. Thus,  useless  lameness  is  present,  or  a  more  than 
specially  keen  search  is  directed  to  the  parts  in  question,  the 
sand-crack  goes  undiscovered,  until  of  greater  dimensions. 

Further,  the  fissure  may  be  hidden,  either  accidentally 
or  of  set  purpose.  It  may  be  covered  by  the  hair,  filled  in 
and  covered  over  with  mud,  or  intentionally  concealed  by 
being  '  stopped  '  with  an  artificial  horn,  with  wax,  or  with 
gutta-percha,  or,  as  is  more  common,  be  hidden  by  the 
lavish  application  of  a  greasy  hoof-dressing. 

In  this  latter  connection  it  is  well  to  warn  the  veterinary 
surgeon,  especially  the  beginner,  when  examining  for  sound- 
ness, to  be  keenly  critical  before  passing  an  animal  who  is 
presented  with  feet  smothered  with  tar  and  grease  or  any 
other  dressing.  More  especially  should  this  warning  be 
heeded  when  examining  any  of  the  heavier  breeds  of  animal 
with  an  abundance  of  hair  about  the  coronet. 

Referring  again  to  the  search  for  the  crack,  it  is  well  to 
know  that  with  toe-crack  the  fissure  is  the  more  readily  seen 
when  the  foot  is  lifted  from  the  ground.  With  quarter- 
crack,  on  the  other  hand,  the  fissure  is  wider,  and  conse- 
quently the  easier  detected  with  the  foot  bearing  weight. 

Although  commencing  in  the  insidious  manner  we  have 
described,  the  lesion  is  not  thus  often  seen  by  the  veterinary 
surgeon.  Usually,  the  animal  with  sand-crack  is  brought 
for  his  inspection  when  lameness  has  arisen  from  it.  In 
this  case  the  cause  for  the  lameness  will  reveal  itself  in  the 
crack,  which  is  now  too  large  to  escape  observation.     The 


166         DISEASES  OF  THE  HORSE'S  FOOT 

coronet  is  hot  and  tender  to  the  touch,  and  a  sensation  of 
warmth  is  sometimes  conveyed  to  the  hand  by  the  horn  of 
the  surrounding  parts  of  the  wall.  It  is  hardly  necessary 
to  say  that,  with  accompanying  conditions  such  as  these, 
the  sand-crack  is  a  deep  one. 

Where  the  lameness  is  but  slight,  we  may  attribute  it 
almost  solely  to  the  pain  occasioned  by  the  mere  wounding 
of  the  keratogenous  membrane,  and  to  no  very  extensive 
inflammatory  changes  therein.  By  some  authorities  this 
is  said  to  be  due  to  the  pinching  of  the  sensitive  structures 
between  the  edges  of  the  fissure  in  the  horny  covering.  In 
our  opinion,  however,  pinching  does  not  occur  unless  in- 
flammatory exudation  into  the  sensitive  structures  adjoin- 
ing the  crack  has  led  to  sufficient  swelling  to  cause  them  to 
protrude.  In  other  words,  the  movements  of  the  horny 
box,  communicating  themselves  to  the  structures  beneath, 
and  so  occasioning  movement  in  the  wounded  keratogenous 
membrane,  are  quite  sufficient  to  give  rise  to  the  lameness 
without  actual  pinching  of  the  structures  implicated. 

The  severity  of  the  lameness  will  vary  with  the  rapidity 
of  the  gait,  and  with  the  character  of  the  road  upon  which 
the  animal  is  made  to  travel.  For  instance,  many  animals 
in  which  the  lameness  is  imperceptible  at  a  walk  become 
'  dead  '  lame  at  a  fast  trot.  It  is  sufficiently  explained 
when  one  remembers  the  greater  movements  of  expansion 
and  contraction  of  the  posterior  parts  of  the  wall  brought 
about  by  the  increase  in  the  rate  of  progression.  The  same 
animal,  too,  will  go  distinctly  more  lame  upon  a  hard  than 
upon  a  soft  surface. 

In  like  manner  the  lameness  from  toe-crack  also  varies  in 
degree  with  the  rate  of  progression  and  the  character  of  the 
travelling,  though  not  to  such  a  noticeable  extent  as  in  the 
lameness  from  quarter-crack-  A  greater  variation  may  in 
this  case  be  brought  about  by  moving  the  animal  on 
ascending  and  descending  ground.  Descending  an  incline, 
with  a  more  than  ordinary  share  of  the  body-weight  thus 
thrown  upon  the  heels,  the  lameness  is  most  marked.  The 
reason  would  appear  to  be  that  the  greater  expansion  of 


DISEASES  FROM  FAULTY  CONFORMATION  167 

the  wall  of  the  heels  thus  brought  about  leads  to  a  pro- 
portionate contraction  of  the  wall  at  the  toe,  especially  at 
the  edges  of  the  crack,  thus  causing  undue  pressure  upon 
the  exact  spot  of  the  wound  in  the  sensitive  structures. 
Ascending — the  weight  in  this  case  transferred  from  the 
posterior  to  the  anterior  portion  of  the  foot — the  expansion 
of  the  heels  becomes  a  contraction,  with  a  corresponding 
lessening  of  the  contraction  at  the  toe  and  a  distinct 
decrease  in  the  lameness. 

In  the  case  of  a  deep  but  recent  crack  there  is  always 
more  or  less  haemorrhage.  This  favours  risk  of  infection 
of  the  lesion  with  pus-forming  organisms,  and  so  leads  to  a 
more  or  less  pronounced  lameness,  a  degree  of  swelling, 
heat  and  tenderness  in  the  coronet  above,  and  a  certain 
amount  of  surgical  fever. 

The  acute  symptoms  subdued,  but  the  fissure  still  remain- 
ing, gives  us  the  crack  we  have  classified  as  '  old.'  This 
may  in  every  case  be  distinguished  from  a  more  recent 
lesion  by  the  amount  of  thickening  of  the  overhanging 
coronet,  and  the  presence  of  an  increased  quantity  of  sub- 
coronary  horn  in  the  region  immediately  about  the  crack. 
The  previous  inflammatory  changes  in  the  adjoining  sensi- 
tive structures  have  here  led  to  an  increased  secretion  of 
lorn,  and  a  greater  or  less  deposition  of  inflammatory  con- 
nective tissue  in  the  wounded  coronary  cushion. 

Sand-crack  of  the  toe  always  follows  the  direction  of  the 
horn  fibres.  That  of  the  quarter,  however,  may  on  occasion 
run  a  course  that  is  somewhat  zigzag,  first  following  the 
direction  of  the  horn  fibres  for  a  short  distance,  then 
travelling  in  a  horizontal  direction,  and  finally  continuing 
its  course  again  in  a  line  with  the  horn  fibres,  commonly 
at  a  point  posterior  to  that  at  which  it  commenced. 

In  a  quarter-crack  that  is  old,  and  when  contraction  of 
the  heels  exists  (which  in  this  case  it  usually  does),  then 
will  often  be  found  overlapping  of  the  edges  of  the  crack. 
The  expansion  of  the  wall  brought  about  when  the  body- 
weight  is  on  the  heels,  cannot,  by  reason  of  the  break  in  it, 
continue  itself  anterior  to  the   crack.     As   a  consequence. 


168        DISEASES  OF  THE  HORSE'S  FOOT 

repeated  expansion  of  the  wall  posterior  to  the  crack,  with 
the  portions  anterior  to  it  in  a  state  of  enforced  quiescence, 
leads  in  time  to  the  posterior  edge  of  the  crack  coming  to 
lie  over  that  of  the  anterior. 

Complications. — The  first  complication  likely  to  arise  in 
a  case  of  sand-crack  is  that  attending  simple  laceration  of 
the  sensitive  structures  in  a  deep  lesion.  With  the  lacera- 
tion all  the  phenomena  of  a  repairing  inflammation  make 
their  appearance.  As  a  result,  there  is  more  or  less  heat 
according  to  the  degree  of  inflammatory  hyperemia,  swell- 
ing according  to  the  amount  of  inflammatory  exudate,  and 
pain  according  to  the  amount  of  pressure  the  two  fore- 
going bring  to  bear  on  the  nerves  in  the  inflamed  area. 

A  second  and  more  serious  complication  is  the  greater 
inflammation  set  up  by  the  introduction  into  the  crack  of 
foreign  substances.  Small  portions  of  gravel  and  flint, 
both  by  the  irritation  set  up  by  their  friction  and  by  the 
infection  they  carry  in  with  the  dirt  surrounding  them,  are 
responsible  for  the  mischief. 

When,  from  direct  communication  with  the  blood-stream, 
due  to  extensive  haemorrhage,  bacteria  from  the  outside  gain 
entrance,  this  simple  inflammation  is  further  complicated 
by  the  formation  of  pus,  or  a  limited  gangrene  of  the 
keratogenous  membrane. 

In  cases  of  great  severity  the  gangrene  of  the  kerato- 
genous membrane  spreds  until  the  deeper  structures  are 
involved.  We  then  get  a  necrosis  (in  the  case  of  toe-crack) 
of  the  extensor  pedis,  and  sometimes  caries  of  the  os  pedis. 

In  like  manner  the  necrotic  changes  occurring  under 
these  circumstances  may  invade  the  deeper  structures  in  the 
region  of  quarter-crack.  As  a  result  of  this,  we  may  have 
the  starting-point  of  suppurating  corn,  or  necrosis  of  the 
lateral  cartilage — in  other  words,  cartilaginous  quittor. 

Commonly  accompanying  quarter-crack  is  the  condition 
of  contracted  heels  and  atrophied  frog.  Sometimes  de- 
scribed as  a  complication  of  sand-crack,  it  appears  to  us 
more  rational  to  rather  regard  the  sand-crack  as  a  result  or 
complication  of  the  vice  of  contraction. 


DISEASES  FROM  FAULTY  CONFORMATION  169 

The  overlapping  of  the  edges  of  the  crack  before  referred 
to  occasionally  gives  rise  to  the  condition  known  as  false 
quittor.  A  probe  or  a  director  passed  beneath  the  over- 
hanging ledge  of  horn  reveals  sometimes  a  fissure  of  1  inch 
or  considerably  more  in  depth,  and  quittor  is  diagnosed. 
A  careful  paring  away  of  the  overhanging  horn,  however, 
reveals  the  true  state  of  affairs,  and  exposes  to  view  the 
original  cause  of  the  mischief — a  simple  fissure  in  the 
wall. 

A  serious  complication — one  fortunately  met  with  but 
rarely — is  that  of  keraphyllocele.  This  is  a  tumour-like 
growth  of  horn,  varying  in  size  from  the  thickness  of  an 
ordinary  quill  pen  to  that  of  one's  middle  finger,  growing 
down  from  the  coronary  cushion,  and  attached  to  the  inner 
side  of  the  wall  of  the  hoof-  With  this  lameness  is  always 
present,  and  more  or  less  deformity  of  the  hoof  results. 
This  condition  will  be  found  described  at  greater  length  in 
Chapter  IX. 

Prognosis. — In  the  case  of  sand-crack  this  should  always 
be  guarded.  It  may  be  taken  as  a  general  rule  that  cracks 
commencing  from  the  coronary  margin  are  more  trouble- 
some to  deal  with  than  those  originating  below.  The 
reason  is  not  far  to  seek.  They  here  affect  the  wall  just 
where  the  bevel  in  it  for  the  accommodation  of  the  coronary 
cushion  has  rendered  it  weakest.  Not  only  is  it  weakest, 
but  being  more  resilient  than  the  portions  below  it,  it  suffers 
more  from  the  alternate  movements  of  expansion  and  con- 
tractoin  of  the  foot  than  does  the  horn  below. 

Although  in  many  cases  a  cure  of  the  existing  crack  may 
be  easily  accomplished,  regard  should  be  paid  to  the  possi- 
bility of  its  recurrence,  either  in  the  same  position  or  else- 
where. Really,  in  offering  an  opinion  as  to  the  future  use- 
fulness of  an  animal  so  affected,  a  greater  attention  should 
be  directed  to  the  animal's  conformation  than  to  the  crack 
itself.  Where  the  vice  of  conformation  giving  rise  to  it 
(as,  for  example,  contracted  heels  or  upright  hoof)  gives 
bope  of  being  remedied,  then  naturally  it  may  be  safely  said 
that  the  liability  to  sand-crack  goes  with  it. 


170        DISEASES  OF  THE  HORSE'S  FOOT 

A  like  favourable  prognosis  may  be  given  in  the  case  of 
cracks  occasioned  by  purely  accidental  causes. 

Ordinarily,  however,  cracks  once  commenced  tend  rather 
to  increase  than  decrease  in  size  and  severity.  From  being- 
superficial  and  incomplete,  they  become  complete  and  deep, 
with  every  unfavourable  circumstance  that  an  increase  in 
size  and  depth  brings  with  it. 

This  much,  however,  may  be  promised  to  the  owner.  A 
simple  crack,  even  though  originating  from  the  coronary 
margin,  is,  in  the  vast  majority  of  cases,  curable-  Under  a 
rational  treatment  its  increase  in  size  may  be  prevented, 
and  a  sound  wall  caused  to  grow  down  from  the  coronet. 

Treatment. — The  principles  governing  the  treatment  of 
sand-crack  are  simple  enough  in  themselves,  if  not  always 
followed  by  success. 

1.  Preventive. 

This,  as  a  rule,  does  not  suggest  itself  until  a  crack  of 
greater  or  less  extent  has  made  its  appearance.  Then, 
simultaneously  with  the  treatment  proper  of  the  lesion, 
preventive  measures  should  be  adopted,  to  aid  both  in  the 
healing  of  the  fissure  already  present,  and  to  ward  off  the 
occurrence  of  others  that  might  be  likely  to  form.  The 
hoof,  if  abnormally  brittle,  should  be  regularly  dressed  with 
a  suitable  ointment  (one  containing  glycerine  for  prefer- 
ence), and  its  horn  kept  as  nearly  as  possible  in  a  normal 
condition.  When  the  condition  of  the  horn  predisposing  to  its 
fracture  is  brought  about  by  excessive  wet,  then  the  appro- 
priate preventive  measures  to  be  adopted  suggest  themselves. 

With  regard  to  the  lesion  itself,  we  may  term  '  preventive 
treatment '  all  those  measures  having  for  their  object  the 
prevention  of  increase  in  the  size  of  the  crack.  They  are 
as  follows : 

(a)  Blistering  the  Coronet. — In  a  simple  case,  where  the 
crack  is  superficial  and  close  under  the  coronary  margin  of 
the  wall,  a  sharp  cantharides  blister  to  the  coronet  imme- 
diately above  it  will  have  the  desired  effect.  An  increased 
secretion   of   horn   is   brought   about,   and   by   this    simple 


DISEASES  FROM  FAULTY  CONFORMATION  171 

means  the  crack  prevented  from  becoming  longer.  Very 
often  this  is  all  that  is  necessary.  In  fact,  we  may  say 
here  that,  no  matter  what  other  treatment  is  adopted,  the 
simultaneous  application  of  a  blister  to  the  coronet  is 
always  beneficial.  To  derive  full  advantages  therefrom, 
the  blistering  should  be  repeated  several  times  at  intervals 
of  about  a  fortnight. 

(b)  Clamping  the  Crock. — When  the  services  of  a  skilled 
smith  are  at  hand,  one  of  the  readiest  methods  of  perform- 
ing this  is  to  draw  the  edges  of  the  crack  together  with  an 
ordinary  horse-nail. 

On  each  side  of  the  crack  a  small  horizontal  furrow  is 
burned  or  cut  into  the  wall,  leaving  the  horn  for  about 
I  inch  on  each  side  of  the  crack  intact.  This  provides  a 
groove  for  the  ends  of  the  clamping-nail  to  rest  in,  and 
brings  them  flush  with  the  outer  surface  of  the  wall.  The 
nail  is  then  driven  carefully  home  through  the  crack,  and 


Fig.  86. — The  Sand-crack  Firing-Iron. 

the  pointed  end  grasped  by  the  farrier's  pincers.  The  edges 
of  the  crack  are  then  drawn  tightly  together  and  the  nail 
firmly  clenched. 

'  The  horse-nails  are  prepared  in  the  ordinary  way  as  for 
driving,  with  the  exception  that  each  is  pointed  on  the 
reverse  side,  to  prevent  puncturing  the  sensitive  structures. 
Before  being  used  the  nails  are  put  in  a  vice,  and  the  head 
hammered  to  form  a  shoulder,  to  prevent  their  being  driven 
too  far  into  the  wall,  and  breaking  out  the  hold.'" 

Before  driving  the  nail  some  operators  burn  or  bore  a 
hole  for  it.  Opinion  seems  to  differ  as  to  whether  this  is 
at  all  necessary. 

A  method  of  clamping  which,  on  account  of  its  simplicity, 
has  become  greatly  popular,  is  that  of  Yachette.  For  this 
operation  is  needed  the  outfit  depicted  in  Figs.  86  and  $7. 

*  Veterinarian,  vol.  xlviii.,  p.  100. 


172        DISEASES  OF  THE  HORSE'S  FOOT 

With  the  special  firing-iron  (Fig.  86)  an  indentation, 
sufficiently  large  to  admit  the  points  of  the  clamp  (Fig.  87), 
is  made  on  each  side  of  the  crack.  The  clamp  is  then 
adjusted,  and  pressed  home  tight  by  means  of  the  sand- 


Fig.  87. — The  Sand-crack  Forceps  and  Clamp. 

crack  forceps  (Fig.  87).  According  to  the  length  of  the 
crack,  one,  two,  or  three  clamps  may  be  necessary. 

Another  useful  clamp,  though  far  more  complicated  in 
its  structure,  is  that  of  Professor  McGill  (Fig.  88). 

'  The  object  of  this  invention  is  to  arrange  on  a  spindle, 
which    is    screw-threaded    at    one    end    with    a    right-hand 


Fig.  88.— McGill's  Sand-crack  Clamp. 

thread  and  at  the  other  with  a  left-hand  thread,  two  clips 
or  clamps,  free  to  travel  on  the  thread,  there  being  a  nut 
between  the  two  which  can  be  turned  by  a  spanner.  The 
clips  are  placed  on  the  hoof,  one  on  each  side  of  the  sand- 
crack,  the  hoof  being  prepared  to  receive  the  instrument 
by  filing  a  groove  or  notch  for  the  clamps  to  fit  into,  and  by 


DISEASES  FROM  FAULTY  CONFORMATION  173 

turning  the  nut  on  the  screw  the  clamps  are  brought  towards 
each  other,  and  the  crack  thus  prevented  from  spreading.'* 

Still  a  further  useful  clamp  is  that  of  Koster.  This  is 
considerably  broader  than  the  clamp  of  Yachette,  and  its 
gripping  edges  are  provided  with  teeth  (see  Fig.  89). 

As  with  the  clamp  of  Yachette  so  with  this,  a  groove  is 
burned  into  the  wall  on  each  side  of  the  crack  for  the 
accommodation  of  the  jaws  of  the  instrument,  and  the 
clamp  itself  pressed  home  by  means  of  a  special  pair  of 
forceps.  This  form  of  clamp  holds  well,  and  has  the 
advantage  of  securing  a  wider  area  of  horn  than  that  of 
Yachette  or  McGill. 


Fig.   89.— Koster's  Sand-crack  Clamp. 

Clamping  by  any  method  should  be  advised  or  under- 
taken only  under  certain  conditions.  The  horn  should  be 
moderately  strong,  and  the  wall  should  be  thick.  This 
practically  restricts  the  use  of  the  clamp  to  cracks  of  the 
toe,  and  it  is  there,  as  a  fact,  they  are  found  of  most 
benefit.  While  burning  the  grooves  for  the  clamp,  and 
while  tightening  the  clamp  itself,  the  animal's  foot  should 
be  on  the  ground  and  bearing  weight  at  the  heels,  thus 
insuring  the  greatest  possible  approximation  of  the  edges 
oi  the  crack. 

With  all  methods  of  clamping  an  untoward  result  is 
sometimes  the  formation  of  a  fresh  crack  at  the  point  of 
insertion  of  the  clamps 

(c)By  the  Use  of  Thin  Metal  Plates. — These  are  of  use 
when  the  horn  of  the  wall  is  too  thin  to  allow  of  clamping, 
and  are  therefore  of  especial  use  in  cracks  of  the  quarters. 

*    Veterinarian,  vol.    lxi.,    p.    141. 


174         DISEASES  OF  THE  HORSE'S  FOOT 

The  plates  are  made  so  as  to  cover  the  greater  part  of  the 
length  of  the  lesion,  and  are  fastened  to  the  wall  by  two  or 
more  screws  on  either  side  of  the  crack.  It  is  an  advan- 
tage to  slightly  let  the  plate  into  the  wall  by  means  of 
fitting  it  hot.  In  a  complicated  crack  the  plate  serves  the 
further  useful  purpose  of  holding  in  position  antiseptic 
pledgets,  and  so  keeping  the  lesion  free  from  dirt  and  grit. 
(d)  By  Various  Methods  of  bandaging  the  whole  Cir- 
cumference of  the  Wall. — In  our  opinion  this  method  of 
attempting  to  secure  immobility  of  the  crack,  and  so  pre- 
vent its  extension,  is  not  often  followed  by  success.  The 
main  objection  to  the  method  is  that  it  subjects  the  whole 
of  the  wall  to  the  same  pressure,  and  does  not  restrict  the 
operation  to  the  point  at  which  it  is  required.     As  in  the 


Fig.  90.— Sand-crack  Belt. 

case  of  the  metal  plate,  however,  this  method  has  the  ad- 
vantage that  antiseptic  dressings  may  be  kept  in  position  in 
the  case  of  a  complicated  crack. 

The  binding  of  the  wall  may  be  accomplished  in  two 
ways.  The  simpler  of  the  two  is  to  merely  apply  the 
sand-crack  belt  depicted  in  Fig.  90.  Beneath  this  should 
be  applied  a  compress  of  tar  and  tow  or  other  material,  and 
the  whole  tightened  up  and  kept  in  position  by  means  of 
the  buckle  and  strap.  This  method  of  binding  admits  of 
after-tightening  should  it  unfortunately  work  loose. 

The  older  method  of  binding  the  wall,  and  one  now  often 
practiced  by  the  smith,  is  to  use  a  quantity  of  so-called 
4  tar-band  '  or  other  stout  cord.  With  this  the  foot  is 
neatly  bound  after  the  manner  of  a  cricket-bat  handle,  and 


DISEASES  FROM  FAULTY  CONFORMATION  175 

all  movement  of  the  crack  apparently  restricted.  There  is 
always  a  tendency,  however,  for  such  a  dressing  to  work 
loose,  and  in  the  case  of  a  complicated  crack  it  has  the 
disadvantage  of  permanently  hiding  from  view  the  changes 
taking  place  in  the  discharge  from  the  fissure. 

(e)  By  wedging  the  Crack. — This  is  the  exact  opposite  of 
clamping.  Whereas  in  clamping  we  obtain  immobility  of 
the  crack  by  keeping  it  fixed  in  the  position  of  greatest 
approximation  of  its  edges,  in  wedging,  the  crack  is  rendered 
free  from  movement  by  maintaining  it  in  that  position 
where  its  edges  are  most  widely  separated.  In  this  case 
the  edges  of  the  crack  are  pared  smooth,  the  cavity  thor- 
oughly cleansed,  and  a  wedge  of  hard  wood  firmly  driven 
in  so  as  to  fit  exactly  the  fissure. 

On  the  face  of  it  it  appears  that  this  procedure  would 
really  tend  to  force  open  and  so  lengthen  the  crack,  especi- 
ally at  its  coronary  extremity.  What  one  should  really 
remember,  however,  is  that  the  crack  is  not  made  wider 
than  before,  but  that  it  is  simply  maintained  in  a  position 
occurring  with  every  contraction  of  the  heels  of  the  foot, 
when  it  is  normally  at  its  widest.  Movement  of  the  edges 
is  thereby  stopped,  the  immediately  surrounding  structures 
are  rested,  and  a  new  growth  of  horn,  free  from  crack, 
induced  to  grow  down  from  the  coronet. 

This  method  of  treatment  only  serves  to  emphasize  the 
fact  that,  with  a  sand-crack  once  formed,  it  is  the  constant 
movement  of  the  parts  that  tends  most  to  keep  it  in  exist- 
ence, and  not  any  particularly  marked  exertion  of  force. 

Some  practitioners,  with  the  wedge,  apply  also  a  clamp, 
thus  assuring  additional  firmness  and  solidity  to  that  por- 
tion of  the  wall  under  treatment. 

The  method  of  wedging  is  undoubtedly  successful,  if 
neatly  performed. 

(/)  By  Surgical  Shoeing. — A  partial  rest  is  given  to  the 
affected  parts  by  easing  the  bearing  of  the  shoe  at  the  point 
required.  This  may  be  done  either  by  removal  of  part  of 
the  wall  at  the  spot  indicated,  or  by  thinning  the  web  of 
the  shoe  in  the  same  position. 


176        DISEASES  OF  THE  HORSE'S  FOOT 

The  former  is  the  method  usually  practised.  Cessation 
of  movement  given  in  this  way  is,  as  we  have  already  said, 
only  partial ;  for,  while  the  effects  of  pressure  and   con- 


Fig.  91. — The  Bearing    'eased'    by  Removal  of  the  Wall. 

cussion  from  below  are  minimized,  the  crack  is  still  able  to 
suffer  from  the  movements  of  expansion  and  contraction 
of  the   foot.        Still,  as  an  auxiliary  to   other  treatments, 


Fig.  92. — The  Bearing    'eased'    by  thinning  the  Web  of 
the  Shoe. 


'  easing  '  of  the  wall  under  the  affected  part  should  always 
be  practised 

Figs.  91  and  92  show  respectively  the  manner  of  '  easing ' 
by  removal  of  the  wall,  and  by  thinning  the  web  of  the 


DISEASES  FROM  FAULTY  CONFORMATION  177 

shoe.  In  this  connection  it  is  necessary  to  point  out  that 
on  no  account  should  '  springing  '  of  the  heels  of  the  shoe 
be  allowed.     Fig.  93  illustrates  the  ill-practice. 

In  this  case,  when  the  entire  weight  is  thrown  on  to  the 
heels,  the  portion  of  wall  posterior  to  the  crack  is  bound 
to  participate  unduly  in  the  downward  movement,  and  so 
tend  to  widening  of  the  crack  at  its  highest  point. 

We  have  already  referred  to  the  matter  of  '  clips.'  In 
no  case,  whether  the  crack  be  at  the  toe  or  in  the  quarters, 
should  a  clip  be  placed  immediately  below  it.  If  the  crack 
is  at  the  toe,  the  usual  clip  should  be  dispensed  with,  and 
a  clip  at  each  side  made  to  take  its  place.  At  the  same  time 
care   should   be   taken   to   avoid   throwing  the   weight    far 


Fig.  93.— The  Bearing  'eased'  by  'springing'  the  Heel  of 
the  Shoe. 

forward.  For  that  reason  a  shoe  with  calkins  or  with  very 
high  heels  should  be  removed,  and  a  shoe  with  an  ordinary 
flat  web  substituted. 

In  the  case  of  quarter-crack,  where  the  constant  move- 
ment of  the  parts  under  expansion  and  contraction  of  the 
foot  makes  itself  most  felt,  it  is  wise  to  apply  a  shoe  with 
clips  fitting  moderately  tight  against  the  inside  of  the  bars. 
By  this  means  movement  will  to  a  very  large  extent  be 
curtailed. 

Where  a  marked  tendency  to  contraction  is  found,  as 
is  often  the  case  with  quarter-crack,  then  the  shoe  with 
the  clips  may  be  rendered  more  marked  in  its  operation 
by  giving  to  the  outer  face  of  each  clip — that  face  applied 
to  the  bar — a  slope  from  above  downwards  and  outwards. 
In  other  words,  a  slipper  shoe  should  be  applied  and  the 


1/8        DISEASES  OF  THE  HORSE'S  FOOT 

contraction  given  equally  as  much  attention  as  the  sand- 
crack  itself. 

Where  the  crack  is  situated  far  back  in  the  quarter,  and 
easing  of  the  bearing  cannot  be  accomplished  without  tend- 
ing to  spring  the  heels,  then  the  most  suitable  shoe  is  a 
bar  shoe.  With  it  the  bearing  may,  of  course,  be  eased  in 
exactly  the  position  required,  and  the  heels  still  allowed  to 
take  their  fair  share  in  bearing  the  body-weight,  and  thus 
assist  in  closing  the  crack.  The  bar  shoe,  if  properly  fitted, 
gives  us  also  a  bearing  on  the  frog,  and  aids  greatly  in 
counteracting  contraction. 

2.   Curative. 

(a)  The  Application  of  Dressings  to  the  Lesion. — In  the 
case  of  a  recent  crack,  deep,  and  attended  with  haemorrhage, 
the  foot  should  be  thoroughly  cleansed.  Where  possible, 
a  constant  flow  of  cold  water  from  a  hose-pipe  should  be 
allowed  to  run  over  the  foot.  By  this  means  the  inflam- 
matory symptoms  will  be  held  in  check  and  pain  prevented. 
Later  the  shoe  may  be  eased  at  the  required  place,  and  a 
blister  applied  to  the  coronet.  This,  with  rest,  will  some- 
times prove  all  that  is  needed. 

Should  a  crack  be  of  old  standing,  and  complicated  by 
the  pressure  of  pus,  a  course  of  hot  poulticing  will  often 
prove  of  benefit.  The  poultice  should  be  medicated  with 
any  reliable  disinfectant,  and  should  be  renewed,  or  at  any 
rate  reheated,  two  or  three  times  daily.  The  crack  itself 
should  be  thoroughly  cleaned  after  the  removal  of  each 
poultice,  and  a  concentrated  antiseptic  solution — such  as 
Tuson's  spts.  hydrarg.  perchlor.,  carbolic  acid,  and  water, 
(I  in  10)  or  liquor  zinci  chlor. — poured  into  it.  On  dis- 
continuing the  poulticing,  the  strength  of  the  antiseptic 
solutions  may  be  decreased,  the  parts  rested  by  correct 
shoeing,  and  a  blister  applied  to  the  coronet  as  before. 

If  these  measures  alone  should  prove  insufficient,  then 
the  surgeon  will  either  fall  back  on  those  we  have  just 
related,  or  proceed  to  methods  next  to  be  described. 

(b)  Immobilizing  the  Crack  by  Means  of  grooving  the 
Wall. — To  our  minds,  this  is  as  ready  and  withal  as  success- 


DISEASES  FROM  FAULTY  CONFORMATION  179 

ful  a  method  of  dealing  with  sand-crack  as  has  yet  been 
devised.  It  may  be  done  in  a  variety  of  ways  :  (1)  By  two 
grooves  arranged  about  the  crack  in  the  form  of  a  V,  as 
Fig.  94;  (2)  by  a  perpendicular  groove  on  either  side  of  the 
crack,  about  1  inch  in  distance  from  it,  and  parallel  with  the 
horn  fibres,  as  Fig.  95  ;  (3)  by  a  single  horizontal  groove 
at  the  extreme  upper  limit  of  the  crack;  (4)  by  drawing 
two  horizontal  grooves,  one  at  its  upper  and  one  at  its 
lower  end  (see  Fig.  96). 


Fig,  94. 


Fig.  95.  Fig.  96. 

In  Figs.  94,  95,  and  96  the  thick  black  lines  illustrate  the  posi- 
tions of  the  various  grooves  made  with  the  firing-iron  for 
the  purpose  of  immobilizing  a  quarter  sand-crack. 


The  points  to  be  observed  in  carrying  out  this  line  of 
treatment  are  simple  enough.  In  all  cases  see  that  the 
crack  is  rendered  as  clean  as  possible  by  the  use  of  suitable 
dressings,  and  if  an  excess  of  horn  is  present  immediately 
around  it,  as  in  the  case  of  a  long-standing  and  complicated 
lesion,  have  it  thinned  down  by  rasping. 

All  that  is  then  needed  is  one  or  two  moderately  sharp, 
flat  firing-irons.  The  groove  is  then  burned  into  the  horn 
in  the  positions  indicated,  and  that  portion  of  the  wall  con- 


180        DISEASES  OF  THE  HORSE'S  FOOT 

taining  the  sand-crack  thus  prevented  from  participating  in 
the  movements  of  the  foot.  For  our  own  part,  we  consider 
the  V"shaPed  incision,  or  either  of  the  horizonal  methods 
oi  grooving,  preferable  to  lines  running  in  the  direction  of 
the  horn  fibres.  With  the  latter  there  is  certainly  a  greater 
tendency  to  the  formation  of  new  cracks  than  with  either 
of  those  we  advocate.  The  V~snaPed  incision  we  consider 
most  suitable  of  all,  for  the  reason  that  by  its  means  a 
greater  degree  of  immobility  is  conferred  upon  the  necessary 
portion  of  the  wall. 

Whichever  method  is  adopted,  care  should  be  taken  to 
carry  the  grooves  deep  enough  into  the  horn,  taking  them 
down  as  near  as  possible  to  the  sensitive  structures.  At 
the  same  time,  especial  care  should  be  exercised  in  not 
carrying  them  too  deep  at  their  extreme  upper  limit,  or  in 
that  case  the  liability  to  the  formation  of  fresh  cracks  in 
those  positions  will  be  greatly  increased. 

After  grooving,  a  sharp  blister  should  be  applied  to  the 
coronet  every  three  or  four  weeks,  and  the  animal,  if  free 
from  lameness,  put  to  work. 

(c)  By  stripping  away  a  V-shaped  Portion  of  the  Wall 
around  the  Crack. — This  method  is  only  indicated  when 
the  crack  is  greatly  complicated  by  the  presence  of  pus,  or 
by  the  growth  of  adventitious  horn  on  the  inner  surface  of 
the  wall.  A  radical  cure  is  thus  obtained,  but  the  animal 
for  a  longer  time  incapacitated  from  work. 

The  operation  is  best  performed  by  first  grooving  a  line 
to  connect  the  points  a  and  c  (Fig.  97).  This  should  run 
immediately  under  the  coronary  margin  of  the  wall,  and 
should  stop  short  of  injuring  the  coronary  cushion  beneath. 
Grooves  forming  the  sides  ab  and  be  of  the  triangular 
piece  of  horn  are  next  made,  and  the  horn  contained  within 
the  lines  ab,  be,  and  ca,  carefully  removed.  The  grooves 
are  the  easiest  made  by  a  cautious  use  of  the  firing-iron' 
The  greater  thickness  of  the  horn  may  thus  be  penetrated, 
and  the  grooves  afterwards  carried  to  their  full  and 
requisite  depth  by  the  use  of  the  drawing-knife. 

With  the  removal  of  the  horn  the  diseased   structures 


DISEASES  FROM  FAULTY  CONFORMATION  181 

are  exposed  to  view.     All  such  should  be  removed  by  a 
free  use  of  the  scalpel,  and  a  suitable  dressing  afterwards 


Fig.  97. 


The    dotted    lines    outline    the   V-shaped   portion    of   wall   to   be 
removed   in   the   treatment   of  complicated   toe-crack. 

applied.     A  necessary  factor  in  the  treatment  is  the  em- 
ployment of   pledgets   of   antiseptic   tow.     With   these   the 


The   dotted   lines    indicate    the    portion    of   wall    to   be   removed 
in  the  complete  operation  for  complicated  toe-crack. 

exposed  tissues  are  covered,  and  the  successive  turns  of  a 
bandage  run  tightly  over  them,  so  as  to  exert  a  moderate 


182         DISEASES  OF  THE  HORSE'S  FOOT 

degree  of  pressure.  When  haemorrhage  has  accompanied 
the  operation,  this  dressing  should  be  removed  on  the  fol- 
lowing day,  the  wound  dressed,  and  the  pledgets  of  tow 
and  the  bandage  renewed.  Any  after-dressing  need  only 
then  be  practised  at  intervals  of  a  week.  Repair  after  this 
operation  is  rapid,  and  takes  place  both  from  the  exposed 
podophyllus  membrane  and  from  the  coronary  cushion. 

(d)  By  stripping  the  Wall  from  the  Coronary  Margin  to 
its  wearing  Edge  on  Either  Side  of  the  Crack. — This  is 
merely  a  more  extensive  application  of  the  method  just 
described,  and  is  only  indicated  in  a  complete  and  com- 
plicated crack  that  has  refused  to  yield  to  other  modes  of 
treatment  (see  Fig.  98). 

As  in  the  previous  case,  a  groove  is  run  from  a  to  c. 
The  grooves  ab  and  dc  are  then  continued  to  the  lower- 
most edge  of  the  wall,  and  the  whole  of  the  wall  wTithin 
these  points  removed.  To  facilitate  removal,  the  white 
line  should  be  grooved  between  the  points  b  and  d.  After- 
treatment  is  exactly  the  same  as  that  just  referred  to. 

B.    COENS. 

Definition. — In  veterinary  surgery  the  term  '  corn '  is 
used  to  indicate  the  changes  following  upon  a  bruise  to 
that  portion  of  the  sensitive  sole  between  the  wall  and  the 
bar.  Usually  they  occur  in  the  fore- feet,  and  are  there 
found  more  often  in  the  inner  than  in  the  outer  heel. 

The  changes  are  those  depending  upon  the  amount  of 
haemorrhage  and  the  accompanying  inflammatory  pheno- 
mena occasioned  by  the  injury. 

Thus,  with  the  haemorrhage  we  get  ecchymosis,  and  con- 
sequent red  staining  of  the  surrounding  structures.  As  is 
the  case  with  extravasations  of  blood  elsewhere,  the  haemo- 
globin of  the  escaped  corpuscles  later  undergoes  a  series  of 
changes,  giving  rise  to  a  succession  of  brown,  blue,  greenish 
and  yellowish  coloration. 

With  the  inflammation  thereby  set  up  we  get  swelling  of 
the  surrounding  bloodvessels,  pain  from  the  compression  of 


DISEASES  FROM  FAULTY  CONFORMATION  183 

the  swollen  structures  within  the  non-yielding  hoof,  and 
moistness  as  a  result  of  the  inflammatory  exudate. 

In  a  severe  case  the  inflammation  is  complicated  by  the 
presence  of  pus. 

Classification. —  Putting  on  one  side  the  classification  of 
Lafosse  (natural  and  accidental),  as  perhaps  wanting  in 
correctness,  seeing  that  all  are  accidental,  and  disregard- 
ing the  suggested  divisions  of  Zundel  {corn  of  the  sole  and 
corn  of  the  wall )  as  serving  no  practical  use,  we  believe, 
with  Girard.  that  it  is  better  to  classify  corns  according  to 
the  changes  just  described. 

Following  his  system,  we  shall  recognise  three  forms : 
(1  )  Dry,  (2)  moist.  (3)  suppurating. 

The  dry  corn  is  one  in  which  the  injury  has  fortunately 
been  unattended  with  excessive  inflammatory  changes,  and 
where  nothing  but  the  coloration  imparted  to  the  horn 
by  the  extravasated  blood  remains  to  indicate  what  has 
happened. 

The  moist  corn  is  that  in  which  a  great  amount  of  in- 
flammatory exudate  is  the  most  prominent  symptom.  It 
indicates  an  injury  of  comparatively  recent  infliction. 

The  suppurating  corn,  as  the  name  indicates,  is  a  corn  in 
which  the  inflammatory  changes  are  complicated  by  the 
presence  of  pus. 

Causes. — The  causes  of  corns  we  may  consider  under  two 
headings — namely,  predisposing  and  exciting. 

Predisposing  Causes. — By  the  heading  of  this  chapter 
we  have  already  intimated  that  corns  are  due  to  faulty  con- 
formation of  the  foot.  It  is,  therefore,  merely  a  descrip- 
tion of  such  shapes  of  foot  as  favour  their  formation  that 
will  need  mention  here. 

The  wide,  flat  foot,  with  low  heels,  may  be  first  con- 
sidered. Here  the  posterior  portions  of  the  sole,  those 
portions  between  the  wall  and  the  bars,  fall  very  largely  in 
the  same  plane  as  the  wearing  surface  of  the  bars  and  the 
wall.  As  a  consequence,  these  portions  of  the  sole  are 
more  prone  to  receive  injury  from  stones  and  rough  roads 
and  from  the  pressure  of  the  shoe. 


184        DISEASES  OF  THE  HORSE'S  FOOT 

The  low  heels,  too,  favour  a  more  than  due  proportion  of 
the  body- weight  being  thrown  on  to  the  posterior  parts  of 
the  foot.  Two  evils,  both  inclining  to  the  production  of 
corn,  result  from  this.  In  the  first  place,  the  sensitive 
structures  of  the  posterior  portions  of  the  foot  are  subjected 
to  undue  pressure  from  above;  secondly,  the  posterior  half 
of  the  foot,  by  reason  of  the  extra  weight  thrown  upon 
it,  is  exposed  also  to  greater  effects  of  concussion  than 
normally  it  should  meet.  Added  to  this  we  find  that  the 
abnormally  flat  condition  of  the  sole  has  resulted  in  a  great 
loss  of  resiliency.  With  undue  pressure  above,  and  a  loss 
of  resiliency  and  added  effects  of  concussion  below,  the 
sensitive  structures  included  between  the  opposing  pedal- 
bone  and  the  horny  sole  are  bound  to  suffer  more  or  less 
bruising  each  time  the  foot  comes  to  the  ground,  especially 
if  the  animal  is  moved  at  a  rapid  pace. 

Writing  here  of  the  effects  of  pressure  and  concussion 
affords  a  fitting  occasion  to  mention  the  fact  that  corns 
occurring  in  feet  affected  with  side-bones  are  always  worse 
than  in  feet  with  normal  elastic  cartilages.  The  explana- 
tion of  this  is  simple,  for  there  can  be  no  doubt  that  the 
loss  of  resiliency  in  the  diseased  cartilage  is  only  another 
aid  to  undue  pressure  and  concussion.  The  sensitive 
structures  are  pinched  between  unyielding  bone  above  and 
practically  unyielding  horn  below. 

Feet  with  high  and  contracted  heels  are  also  predisposed 
to  corn.  The  contraction  in  this  case  interferes  with  the 
downward  movements  of  the  os  pedis  during  progression, 
while  in  a  state  of  rest  there  is  a  more  or  less  constant 
pressure  upon  the  sensitive  structures,  due  to  the  correct 
downward  displacement  of  the  pedal-bone  being  opposed  by 
the  amount  of  contraction  present.  In  the  contracted  foot, 
too,  the  nutrition  of  the  vessels  supplying  the  secretory 
apparatus  of  the  horn  is  largely  interfered  with.  The  horn 
loses  is  natural  elasticity,  fails  to  respond  to  the  normal 
movements  of  the  parts  within,  and  aids  in  the  compression 
and  laceration  of  the  sensitive  structures. 

Weak  feet,  with  horn  too  thin  to  withstand  the  expansive 


DISEASES  FROM  FAULTY  CONFORMATION  185 

movements  continually  going  on — in  other  words,  feet  with 
weak,  spreading  heels — are  also  prone  to  suffer  from  corns. 
In  this  case  the  flatness  induced  by  the  spreading,  and  the 
insufficient  protection  afforded  by  the  thin  horn,  both  com- 
bine to  lay  the  sole  open  to  the  effects  of  concussion  and 
direct  injury. 

Brittle  feet — feet  with  horn  of  undue  dryness,  by  reason 
of  the  contraction  thus  brought  about — are,  again,  particu- 
larly subject  to  corn. 

So  also  with  long  feet.  Whether  occurring  as  a  natural 
deformity,  or  as  the  result  of  insufficient  paring,  bruises  of 
the  sole  in  feet  thus  shaped  are  common.  The  reason  for 
this  will  be  better  understood  when  we  come  to  deal  with 
the  shoeing. 

Other  and  minor  predisposing  causes  are  those  mainly 
referring  to  an  unnatural  dryness  of  the  hoof  when 
animals  reared  in  the  country  are  put  to  work  in  large 
towns.  We  here  really  get  several  predisposing  causes 
combining.  A  sudden  change  is  made  from  a  more  or  less 
moist  condition  underfoot  to  one  excessively  dry.  The 
character  of  the  traveling  is  wholly  altered  from  occasional 
work  upon  soft  lands  to  continual  labour  upon  hard-paved 
roads.  The  horn  is  often  exposed  to  the  vicious  influences 
of  unsuitable  litter,  the  application  of  unsuitable  dressings, 
and  the  deleterious  effects  of  the  street  mud  of  our  cities. 
All  these  play  their  part  in  determining  a  condition  of  the 
horn,  rendering  it  open  to  receive  the  effects  of  the  more 
exciting  causes  which  we  shall  next  consider. 

Exciting  Causes. — Than  the  shoeing,  no  more  frequent 
and  exciting  cause  of  corn  exists.  Whatever  the  predis- 
posing influences  may  be,  it  is  the  shoeing  that  in  nearly 
every  case  completes  the  list,  and  finally  inflicts  the  injury. 

The  evils  in  this  connection  we  shall  consider  under  two 
headings — viz.,  (1)  the  manner  in  which  the  foot  is  pared; 
(2)  the  make  and  fitting  of  the  shoe. 

First  among  the  faulty  preparations  of  the  foot  comes 
that  of  excessive  thinning  of  the  sole,  especially  in  the 
regions  subject  to  corn.    The  farrier  addicted  to  this  is  not 


186        DISEASES  OF  THE  HORSE'S  FOOT 

as  a  rule  content  to  confine  his  operations  to  the  sole  alone. 
In  addition,  the  frog  and  the  bars  also  suffer  from  the  too 
lavish  use  of  his  knife.  His  main  object  is  doubtless  that 
of  giving  a  broad  and  open  appearance  to  the  foot.  It 
follows  from  this  that  his  operations  are  confined  more  to 
the  posterior  than  the  anterior  parts  of  the  foot,  and  that 
the  toe  is  therefore  left  too  long.  This  gives  us  a  com- 
bination of  causes  leading  to  pressure  and  bruises  upon  the 
sensitive  structures  at  the  seat  of  corn. 

By  this  unequal  paring  of  the  toe  and  the  heels  greater 
weight  is  thrown  upon  the  posterior  half  of  the  foot 
What  then  happens  to  the  structures  thinned  as  we  have 
described  is  this :  the  pared  frog,  lessened  in  volume,  does 
not  meet  the  ground.  It  therefore  fails  to  expand  laterally 
with  weight,  and  cannot  assist,  as  normally  it  should,  in 
aiding  the  heels  generally  in  their  movements  of  expansion. 
The  weakened  bars  and  the  thinned  sole,  meeting  with  no 
opposition  from  the  frog,  give  downwards  and  inwards  with 
the  body-weight  at  the  precise  moment  these  movements 
should  be  directed  mainly  outwards.  As  a  further  result 
of  non-resistance  on  the  part  of  the  frog,  this  time  in  a 
lateral  direction,  the  bars,  the  sole,  and  the  wall  at  the  heels 
all  contract  at  the  exact  time  they  should  expand.  The 
end  result  must  mean  abnormal  pressure  and  bruising  of 
the  sensitive  structures  in  that  particular  region.  Naturally, 
also,  the  excessive  thinning  of  the  horn  renders  direct 
injury  to  the  sole  from  stones  or  other  objects  in  the  road 
far  more  probable. 

For  this  one  reason  alone — the  manner  in  which  it 
favours  the  production  of  corn — too  great  a  condemnation 
cannot  be  placed  upon  excessive  paring  of  the  sole,  the 
bars,  and  the  frog. 

When  corns  are  already  present,  as  they  may  be  from 
other  causes,  the  same  remarks  will  again  apply  to  ex- 
cessive paring.  It  is  the  custom  with  many  smiths  to 
carefully  pare  down  the  discoloured  horn  in  every  case  of 
corn  they  meet  with,  and  at  the  same  time  to  .again  weaken 
the  bars  and  even  part  of  the  wall  at  the  heels,  with  the 


DISEASES  FROM  FAULTY  CONFORMATION  187 

laudable  idea  of  relieving  pressure  on  the  part  diseased. 
After  what  has  gone  before,  we  need  hardly  say  that  their 
well-meant  efforts  have  a  precisely  opposite  effect  to  the 
one  they  intend. 

The  fitting  of  the  shoe  is,  perhaps,  to  a  greater  extent 
responsible  for  the  causation  of  corn  than  is  the  paring  we 
have  just  described. 

A  few  of  the  evils  connected  with  the  shoe  may,  however, 
be  justly  described  as  unavoidable.  We  must  shoe;  we 
cannot  shoe  and  leave  a  normal  foot ! 

A  shoe  excessively  seated,  especially  from  the  last  nail- 
hole  backwards,  may  be  regarded  as  dangerous.  In  this 
case,  with  every  application  of  the  body-weight,  there  is 
given  to  the  foot  a  tendency  to  contract,  especially  at  its 
lower  margin.  Result :  undue  pressure  upon  the  tissues 
around  and  the  production  of  corn. 

On  the  other  hand,  varying  with  the  form  of  foot,  the 
seating  may  be  insufficient.  In  the  case  of  flat-foot,  or 
dropped  sole,  for  instance,  insufficient  seating  will  lead  to 
undue  pressure  of  the  web  of  the  shoe  upon  the  sole,  and 
in  that  way  bring  about  bruising  of  the  sensitive  sole 
beneath. 

Shoes  with  heels  or  calks  too  high,  by  destroying  the 
counter-pressure  of  the  frog  with  the  ground,  serve  to  bring 
about  a  series  of  changes  we  have  described  under  contrac- 
tion, and  again  result  in  pinching  and  bruising  of  the  sensi- 
tive structures. 

The  opposite  excess — a  shoe  thick  at  the  toe  and  thin  at 
the  heels — is  blamed  by  Zundel  for  causing  a  like  injury. 
In  our  opinion,  the  reason  this  author  gives — namely,  that 
the  throwing  of  greater  weight  upon  the  heels  leads  to 
bruising  of  the  sensitive  structures — can  only  correctly 
apply  to  a  zvro  ugly-applied  shoe  of  this  type,  and  not  to  the 
shoe  itself.  True,  a  shoe  with  a  thick  toe  and  thinned 
heels  will  throw  an  undue  proportion  of  the  body-weight 
upon  the  heels  if  the  foot  is  not  properly  prepared  for  it. 
A  wise  man,  however,  will  most  certainly  so  cut  down  the 
toe   for  the  reception  of  this  shoe  that,  with  the  shoe  in 


188        DISEASES  OF  THE  HORSE'S  FOOT 

position,  there  will  still  be  maintained  a  tread  that  is  normal. 
To  our  minds  harm  is  far  more  likely  to  arise  from  a  shoe 
of  this  class  through  the  thinned  iron  heels  of  the  shoe  be- 
coming attenuated  under  wear  to  the  point  of  bending,  and 
so  inflicting  an  injury  upon  the  adjoining  sole. 

Similarly,  this  last  remark  with  regard  to  the  thinning 
of  the  heels  of  the  shoe  will  apply  to  a  shoe  with  too  broad 
a  web.  As  the  thinning  of  the  shoe  proceeds  with  wear,  the 
inner  portion  of  the  thinned  branch  is  bent  up  on  to  the 
sole,  and  again  inflicts  the  injury. 

The  matter  of  bearing  is  also  of  importance  when  con- 
sidering the  causation  of  corn.  In  a  previous  chapter  we 
have  already  described  the  correct  bearing  as  that  which 
includes  the  whole  of  the  lower  margin  of  the  wall  and  the 
white  line,  and  just  impinges  on  the  sole.  Any  marked 
deviation  from  that  will,  if  long  continued,  be  followed  by 
injury  to  the  foot. 

With  the  bearing  surface  of  the  shoe  too  narrow — in 
;ontact  with  the  wall  solely,  or  perhaps  only  a  portion  of 
it — it  is  evident  that  a  large  proportion  of  the  foot  that 
should  properly  bear  weight  is  thrown  out  of  action.  A 
leavy  strain  is  imposed  on  the  white  line,  and  undue  descent 
of  the  sole  and  contraction  of  the  heels  brought  about. 
Again  the  result  of  this  is  compression  and  bruising  of  the 
tissues  around  the  seat  of  corn. 

With  its  bearing  surface  too  wide,  the  shoe  immediately 
eserts  direct  pressure  upon  the  sole  with  every  movement 
cf  the  animal.  The  sole  normally  is  not  made  to  receive 
uhis,  and  harm  is  bound  to  result. 

Among  other  ill-fitting  shoes  we  may  mention  the  one 
with  branches  too  short,  and  the  one  with  the  extremities 
of  the  branches  too  pointed.  In  the  first  case,  as  wear  of 
the  shoe  proceeds,  the  thinned  end  is  far  more  likely  to 
turn  in  under  the  seat  of  corn  than  is  a  shoe  with  branches 
of  ordinary  correct  length.  It  is  evident  in  the  second 
case  that  the  pointed  branch,  when  thinned,  is  a  more 
dangerous  agent  than  the  branch  which  is  nearer  the  square 
at  its  end. 


DISEASES  FROM  FAULTY  CONFORMATION  189 

The  matter  contained  in  the  first  half  of  the  foregoing 
paragraph  explains  in  a  large  measure  the  rarity  of  corns 
in  the  hind-feet.  Here  there  is  nothing  to  prevent  a  shoe 
with  branches  of  full  length  being  used.  The  correct  bearing 
is  thus  maintained,  even  with  a  shoe  excessively  thinned  with 
wear,  and  the  liability  to  injury  from  it  decreased.  An 
exception  is  to  be  found  in  the  case  of  a  feather-edged  shoe, 
such  as  is  used  to  prevent  cutting  or  brushing.  The  thin- 
ning by  wear  from  above  to  below  of  the  branch  already 
purposely  thinned  from  side  to  side  leads  to  the  formation 
of  a  thin  and  narrow  piece  of  iron  admirably  calculated  to 
bend  over  and  injure  the  sole. 

Even  with  a  shoe  of  correct  length,  with  a  flat-bearing 
surface  at  the  heels,  and  other  conditions  favourable  to 
correct  application,  evil  may  still  result  from  the  shoe  itself 
being  made  too  narrow.  As  a  result  of  this,  the  branch  of 
each  side  is  set  too  far  under  the  foot,  with  consequent 
injury  to  the  sole.  This  is,  of  course,  sheer  carelessness 
on  the  part  of  the  smith.  When  practised,  however,  it  is 
not  easy  of  detection,  as  in  all  cases  the  foot  is  rasped  down 
to  cover  what  has  been  done.  In  other  words,  the  foot  is 
made  to  fit  the  shoe  and  not  the  shoe  the  foot. 

Recognising  this  close  fitting  of  the  shoe  as  a  cause,  we 
are  able  to  explain  in  some  measure  how  it  is  that  corns 
should  occur  with  greater  frequency  in  the  inner  than  in 
the  outer  heel.  There  is  no  doubt  that  the  inner  branch  of 
the  shoe  is  nearly  always  fitted  closer  than  is  the  outer. 
In  the  fore-foot  it  is  also  often  shorter.  Take  these  two 
evils  and  add  to  them  the  fact  that  the  inner  heel  is  called 
upon  to  bear  more  of  the  body-weight  than  is  the  outer, 
and  the  frequency  of  corns  in  the  inner  heel  will  no  longer 
be  wondered  at. 

Indirectly,  the  shoe  may  still  be  a  cause  of  corn  by 
reason  of  the  irritation  set  up  by  gravel  and  small  pieces 
of  flint  becoming  firmly  fixed  between  the  sole  and  the 
web  of  the  shoe.  In  nearly  every  case  of  this  description 
the  part  to  be  injured  is  the  white  line. 

Corns   may   also   result    from   the   animal   picking   up   a 


190        DISEASES  OF  THE  HORSE'S  FOOT 

stone.  The  stone  becomes  firmly  wedged  in  between  the 
inner  border  of  the  branch  of  the  shoe  and  the  bar  or  the 
frog.  With  every  step  the  animal  takes  it  becomes  wedged 
more  tightly  into  position.  Projecting  below  the  level  of 
the  lower  surface  of  the  shoe,  it  imparts  the  concussion 
it  thus  obtains  directly  to  the  sole.  A  bruise — and  a  bad 
bruise — is  the  result. 

Finally,  it  cannot  be  denied  that  the  work  the  horse  is 
put  to  is  largely  responsible  for  the  causation  of  corn.  In 
country  animals  corns  are  comparatively  rare,  while  in 
animals  in  town,  almost  constantly  upon  hard  paving,  they 
are  common.  This  seems  to  point  strongly  to  the  fact  that 
concussion  through  constant  work  upon  unyielding  roads  is 
a  great  factor  in  their  production. 

Symptoms. — Unless  the  discoloration  of  the  horn  is 
accidentally  discovered  by  the  smith,  the  simple,  dry  corn 
may  go  undetected.  The  disturbance  excited  by  it  is  so 
small,  and  the  pain  occasioned  so  slight,  that  the  patient 
may  offer  no  indication  of  its  existence. 

Ordinarily,  however,  the  first  symptom  is  that  of  pain. 
The  animal  goes  feelingly  with  one  or  both  feet,  in  some 
cases  even  showing  decided  lameness.  The  lameness,  how- 
ever, is  in  no  way  diagnostic,  and  the  lesion  itself  must  be 
discovered  before  an  exact  opinion  can  be  pronounced. 

As  an  aside,  it  is  well  to  observe  in  this  connection  that 
a  negative  opinion  as  to  the  existence  of  corn  should  never 
be  given  unless  the  superficial  layers  of  horn  have  first 
been  removed  with  the  knife. 

When  standing  at  rest  the  animal  exhibits  signs  more  or 
less  common  to  all  foot  lamenesses.  He  '  points  '  the  foot — 
in  other  words,  the  limb  is  slightly  advanced,  the  fetlock 
partly  flexed,  and  the  heels  from  off  the  ground.  When 
both  feet  are  affected  they  are  pointed  alternately,  and  the 
animal  often  manifests  this  uneasiness  by  repeated  pawing 
movements,  and  by  scraping  his  bedding  behind  him. 

Should  the  injury  run  on  to  suppuration,  the  lameness 
becomes  most  acute.  The  pawing  movements  become  more 
pronounced,  and  there  is  evident  disinclination  on  the  part 


DISEASES  FROM  FAULTY  CONFORMATION  191 

of  the  animal  to  place  the  foot  squarely  on  the  ground. 
( )ne  is  then  led  to  manipulate  the  foot.  The  hoof  is  hot  to 
the  touch.  Percussion  causes  the  animal  to  flinch,  and  to 
finch  particularly  when  that  portion  of  the  wall  adjoining 
the  corn  is  struck.  Finally,  exploration  with  the  knife 
reveals  the  serious  extent  to  which  the  injury  has  developed. 
In  a  neglected  case  of  this  description  it  is  even  possible  to 
detect  the  presence  of  pus  by  the  amount  of  swelling  and 
fluctuatiing  condition  of  the  coronet.  The  suppurative  pro- 
cess has  advanced  in  the  direction  of  least  resistance,  and 
is  on  the  point  of  breaking  through  the  tissues  immedi- 
ately above  the  horn. 

Lameness  due  to  corn  is  oftentimes  intermittent.  With 
a  simple  corn,  dry  or  moist,  this  intermission  is  largely 
dependent  on  the  degree  of  dryness  of  the  hoof  or  the  road, 
and  also  on  the  character  of  the  road  surface.  With  a 
neglected,  suppurating  corn,  on  the  other  hand,  variation 
in  the  degree  of  lameness,  in  addition  to  depending  on 
circumstances  such  as  these,  is  dependent  to  a  larger 
extent  upon  the  changes  occurring  with  the  suppuration. 
In  this  case  the  time  of  greatest  lameness  is  immediately 
before  the  pus  gains  outlet.  Immediately  after  its  exit  at 
the  coronet  the  animal  will  go  almost  sound.  Soundness 
continues  as  long  as  the  opening  at  the  coronet  remains 
clear.  The  tendency,  however,  is  for  the  opening  thus 
made  to  quickly  close  again.  Pus  again  accumulates, 
lameness  arises  as  before,  and  disappears  again  with  the 
second  discharge  of  the  contents  of  the  sinus  now  formed. 

Pathological  Anatomy. — When  dealing  with  their  classifi- 
cation we  gave  in  outline  the  main  pathological  changes  to 
be  met  with  in  corns.  It  now  only  remains  to  give  the 
same  matter  in  slightly  greater  detail. 

In  dry  com  the  changes  we  meet  with  are  those  accom- 
panying blood  extravasation.  From  excessive  compression 
of  the  parts,  or  from  the  effects  of  direct  injury,  a  portion 
of  the  sensitive  sole  has  become  lacerated.  The  escaping 
blood  stains  the  surrounding  soft  tissues  after  the  manner 
of  blood  extravasation  elsewhere.    If  the  escape  of  blood  is 


192 


DISEASES  OF  THE  HORSE'S  FOOT 


sufficiently  large,  the  horn  fibres  in  the  immediate  vicinity 
also  are  stained.  It  is  this  stain  in  the  horn  that  is  the 
direct  evidence  of  the  injury,  and  is  itself  popularly  known 
as  the  corn.  It  may  vary  in  size  from  quite  a  small  spot 
to  a  broad  patch  as  large  as  half  a  crown,  while  its  colour 
may  be  a  uniform  red,  or  a  mottled  red  and  white.     The 


Fig.  99. — Horizontal  Section  of  a  Corn. 

The  section  cut  at  about  the  base  of  the  papillae  of  the 
sensitive  sole. 

a,  Papillae,  with  horn-cells  surrounding  them;  b,  interpapillary 
or  intertubular  horn;  c,  hollow  spaces  in  the  intertubular 
material  filled  with  blood;  d,  a  papilla  and  its  surrounding 
horn-cells  filled  with  blood. 

microscopic   changes   in  this   connection  are  illustrated   in 
Fig.  99. 

Ordinarily,  this  ecchymosis  of  the  horny  sole  is  due  to 
injury  of  the  sentitive  sole  immediately  beneath  it.  It  may, 
however,  proceed  from  injury  to  the  vessels  of  the  laminae 
either  of  the  bars  or  of  the  wall.     In  this  case  the  ecchy- 


DISEASES  FROM  FAULTY  CONFORMATION  193 

mosis  of  the  horny  sole  may  be  explained  by  the  fact  that 
the  escaped  blood  tends  to  gravitate  to  that  position. 

When  the  corn  is  of  long  standing,  or  is  due  to  repeated 
injuries  on  the  same  spot,  the  horn  adjacent  to  the  lesion 
becomes  hard  and  dry,  and  often  abnormally  brittle,  simply 
on  account  of  the  inflammatory  changes  thus  kept  in  con- 
tinuation. This  is  often  seen  when  attempts  are  made  to 
pare  out  the  corn  with  the  knife. 

Should  the  injury  be  seated  in  the  sensitive  laminae,  then 
the  brittle  nature  of  the  horn  secreted  by  the  injured  tissues 
makes  itself  apparent  by  the  appearance  of  cracks  in  the 


Fig.   100. — Inner  Surface  of  the  Wall  of  the  Quarter,  showing 
Changes  in  the  Horny  Laminae  brought  about  by  Chronic  Corn. 

wall  of  the  quarter.  Why  this  should  occur  will  be  readily 
understood  by  a  reference  to  Fig.  100. 

It  will  here  be  seen  that  the  injury  to  the  keratogenous 
membrane  has  led  to  great  interference  with  the  secretion 
of  horn  from  the  sensitive  laminae.  As  a  result,  the  regu- 
larly leaf -like  arrangement  of  the  horny  laminae  has  been 
largely  broken  up.  Certain  of  the  laminae  are  altogether 
wanting,  while  others  are  broken  in  their  length  and 
rendered  incomplete.  With  this  condition  there  is  always 
more  or  less  contraction  of  the  quarter. 

Microscopic  examination  of  the  structures  involved  in 
such  a  case  reveals  the  fact  that  with  the  contraction  is  an 


194         DISEASES  OF  THE  HORSE'S  FOOT 

alteration  in  the  normal  direction  of  the  horny  and  sensitive 
laminae. 

They  become  bent  backward,  and,  instead  of  the  regular 
and  normal  arrangement  depicted  in  Fig.  32,  show  the 
distorted  appearance  given  in  Fig.  101. 

From  the  appearances  and  characters  of  the  blood-stain 


A'1 


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A 


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V 


KT 


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y 


Fig    101. — Perpendicular   Section   of  the   Wall   of   a   contracted 
Quarter  in   a   Case   of   Chronic   Corn. 

Both  the  sensitive  and  horny  laminae  are  bent  backwards,  and 
haemorrhages  have  taken  place  at  the  base  of  the  sensitive 
laminae. 

m  the  horny  sole  we  are  able  to  deduce  evidence  relative  to 
the  duration  and  nature  of  the  injury. 

When,  for  instance,  the  stain  is  not  to  be  found  in  the 
superficial  layers  of  the  sole,  but  is  only  discoverable  by 
deep  paring,  then  the  injury  is  a  recent  one. 

Where  the  stain  is  met  with  in  the  superficial  layers,  of 
horn,  and  is  quickly  pared  out,  then  the  injury  has  been 
inflicted  Some  time  before,  and  has  not  been  repeated. 


DISEASES  FROM  FAULTY  CONFORMATION  195 

When,  as  is  sometimes  the  case,  layers  of  horn  that  are 
stained  are  found  alternated  with  layers  that  are  healthy, 
then  we  have  evidence  that  the  cause  of  the  corn,  whatever 
it  may  be,  is  not  in  constant  operation. 

Similar  indication  of  the  age  of  the  injury  is  also 
afforded  by  the  colour  of  the  lesion. 

A  stain  that  is  deep  red  is  proof  that  the  injury  is  com- 
paratively recent. 

A  distinct  yellow  or  greenish  tinge,  on  the  other  hand,  is 
evidence  that  the  injury  is  an  old  one. 

In  the  Moist  Com  we  have,  in  addition  to  the  blood  ex- 
travasation, the  outpouring  of  the  inflammatory  exudate. 
In  the  most  superficial  layer  of  the  horn  this  may  not  be 
noticeable.  As  one  cuts  deeper  into  the  sole  with  the  knife, 
however,  it  will  be  found  that  the  lower  layers  of  horn  are 
more  or  less  infiltrated  with  the  discharge.  This  gives  to 
the  horn  a  soft  consistence,  a  yellow  appearance,  and  a 
touch  that  is  moist  to  the  fingers. 

With  the  accompanying  inflammation  the  cells  in  the 
neighborhood  of  the  injury  are  enfeebled  and  their  normal 
functions  interfered  with.  We  may  thus  expect  a  corre- 
sponding interference  with  the  growth  of  horn.  This  is 
exactly  what  happens,  and  as  one  cuts  deeper  still  into  the 
horn  a  point  is  finally  reached  when  a  well-marked  cavity 
is  encountered.  A  pale  yellow  and  usually  watery  exudate 
fills  it.  This  cavity  points  out  the  exact  spot  where  the 
force  of  the  injury  has  been  greatest,  where  death  of  certain 
cells  of  the  keratogenous  membrane  has  resulted,  and  where 
the  natural  formation  of  horn  has  for  a  time  been  sus- 
pended. 

In.  the  Suppurating  Com,  as  in  moist  corn,  we  have 
pathological  changes  due  to  the  tissue  reaction  to  the 
injury,  plus  the  addition  of  pus  organisms.  Confined 
within  the  horny  box  we  have  a  discharge  that,  by  reason 
;  of  the  .living  and  constantly  multiplying  elements  it  con- 
tains—the  -  pus-  organisms — is  always  increasing  in  bulk. 
I  This  must  be  at  the  expense  of  the  softer  structures  of  the 
foot.     Accordingly,  as  the  formation  of  pus  increases,  we 


196        DISEASES  OF  THE  HORSE'S  FOOT 

get  pressure  upon  and  final  gangrene  of  the  sensitive  sole 
and  of  the  sensitive  laminae  of  the  bars  and  the  wall. 
With  no  outlet  below,  the  pus  formation  increases  until 
finally  it  finds  its  way  out  of  the  hoof  by  emerging  at  the 
coronet. 

This  in  some  instances  it  may  do  by  confining  its  necrotic 
influences  solely  to  the  sensitive  laminae  of  the  wall,  in 
which  case,  if  a  dependent  orifice  is  quickly  made  at  the 
sole,  the  injury  to  the  laminae  is  soon  repaired  by  the  healthy 
tissue  remaining. 

In  other  cases,  however,  the  necrosis  has  spread  deeper. 
Caries  of  the  os  pedis,  of  the  lateral  ligaments  of  the  pedal- 
joint,  or  of  the  lateral  cartilages,  is  a  result.  When  this 
occurs  the  exuding  discharge  from  the  coronet  becomes 
thinner  and  more  putrescent,  and  its  feel,  when  rubbed 
between  the  fingers,  sometimes  gritty  with  minute  frag- 
ments of  broken-up  bone.  Here,  unless  operative  measures 
prevent  it,  necrosis  soon  spreads  deeper  still.  The  deeper 
portions  of  the  os  pedis  become  affected.  The  capsular 
ligament  of  the  joint  is  penetrated  by  the  suppurative  pro- 
cess, and  a  condition  of  septic  arthritis  results.  The  cavity 
of  the  joint  becomes  more  or  less  tensely  distended,  accord- 
ing to  the  amount  of  drainage  present,  which  in  this  case 
is  almost  nil,  with  matter  in  a  state  of  putrescence.  As  a 
consequence,  the  surrounding  ligaments  become  softened 
and  yield,  and  the  articular  surfaces  displaced.  The 
articular  cartilages  also  suffer,  become  necrotic  in  patches, 
and  frequently  wholly  destroyed.  The  end  result  is  one  of 
anchylosis  of  the  joint  and  permanent  lameness. 

Prognosis. — With  the  ordinary  dry  corn  a  return  to  the 
normal  may  nearly  always  be  looked  for.  Similarly,  with 
moist  corn,  and  even  with  careful  treatment  of  the  suppu- 
rating variety,  the  same  favourable  termination  may  be 
looked  for  and  promised. 

What  cannot  so  safely  be  assured  is  that  a  relapse  will 
not  occur.  In  other  words,  the  extent  of  the  injury,  no 
matter  how  serious,  does  not  often  offer  anything  that 
cannot  be  overcome  by  Nature  and  careful  surgery;  but 


DISEASES  FROM  FAULTY  CONFORMATION  197 

the  conformation  of  the  animal  does.  A  vicious  predis- 
posing conformation  once  there  is  there  always,  and 
although  the  injury  resulting  from  it  may  easily  give  way 
to  correct  treatment,  the  same  injury  is  bound  to  re-occur 
when  the  animal  is  again  put  to  work. 

Although  with  care  suppurating  corn,  like  other  cases  of 
suppuration  within  the  hoof,  may  yield  to  treatment,  the 
owner  of  the  animal  should,  nevertheless,  be  warned  that 
the  condition  is  a  serious  one,  especially  should  the  joint 
become  affected.  It  may  so  happen,  as  sometimes  in  fact 
it  does,  that  the  animal  may  die  as  a  result  of  the  infective 
fever  so  set  up.  From  no  surface  in  the  body  can  absorp- 
tion take  place  quicker  than  from  the  synovial  membrane 
of  a  joint.  So  soon,  therefore,  as  this  membrane  comes  in 
contact  with  septic  material,  so  soon  does  a  severe  septic 
fever  make  its  appearance.  The  septic  matter  has  gained 
the  blood-stream,  and  the  patient  succumbs  to  septic 
poisoning. 

Apart  from  death  occurring  naturally,  the  changes  taking 
place  in  the  joint  in  the  shape  of  bony  growths  or  of  actual 
anchylosis  may  be  so  severe  as  to  render  the  animal  useless, 
and  slaughter  may  have  to  be  advised. 

Treatment. — We  have  already  said  that  by  far  the  most 
active  cause  in  the  production  of  corn  is  the  shoe.  It 
follows  from  this  that  it  is  to  the  shoeing  we  must  largely 
look  for  a  successful  means  of  their  prevention,  and  that 
the  treatment  of  corn  in  its  most  simple  form  is  really  a 
matter  for  the  smith,  and  not  for  the  veterinary  surgeon. 

The  faults  in  connection  with  the  shoeing  we  have  men- 
tioned fully  when  treating  of  the  causes  of  corn.  From 
those  we  learn  that  a  shoe  with  a  flat-bearing  surface,  or 
one  moderately  seated  but  flat  at  the  heels,  is  the  correct 
shoe  for  nearly  all  feet.  The  heels  of  me  shoe  should  not 
be  too  high,  should  not  be  too  short,  and  should  be  wide 
enough  apart  from  each  other  to  insure  the  wall  of  the  foot 
obtaining  a  fair  share  of  the  bearing.  Finally.,  even  with 
the  present  method  of  shoeing,  whenever  it  is  possible  to 
allow  the  frog  to  come  to  the  ground,    it    should    be    en- 


198         DISEASES  OF  THE  HORSE'S  FOOT 

couraged  to  do  so,  and  excessive  paring  either  of  the  latter 
organ  or  of  the  bars  or  the  sole  should  be  strictly  dis- 
countenanced. When  the  sole  is  thin,  or  the  frog  wasted, 
use  a  leather  sole  or  a  rubber  pad.  With  these  precautions, 
corns  may  be  prevented  from  occuring  even  in  a  foot  with 
a  predisposing  conformation. 

When  corn  is  present,  the  first  treatment  usually  adopted 
is  that  of  '  paring  it  out.'  This  is  advocated  by  Percival 
and  by  many  other  writers.  We  cannot  say,  however,  that 
we  agree  with  it — at  any  rate,  not  in  the  case  of  simple  dry 
corn. 

'  Paring  it  out,'  and  by  that  we  mean  thinning  down  the 
sole  until  close  on  the  sensitive  structures,  can  only  be 
advised  in  the  case  of  suppurating  corn,  or  in  cases  where 
doubt  exists  as  to  whether  pus  is  present  or  not.  In  the 
latter  case  paring  becomes  necessary  as  an  exploratory 
means  to  diagnosis. 

When  it  appears  fairly  certain,  even  in  the  case  of  a 
moist  corn,  that  pus  does  not  exist,  then  paring  is  to  be 
discountenanced,  for  the  reason  that  it  only  tends  to 
weakening  of  the  parts  and  to  assist  largely  in  the  corn's 
recurrence. 

Those  who  advocate  it  do  so  for  the  reason  that  it  relieves 
pressure  on  the  injured  parts. 

That  it  does  so  directly  from  below  cannot  be  denied ; 
but  that  it  also  favours  contraction  and  compression  from 
side  to  side  is  equally  certain. 

A  moderate  paring  may,  however,  be  indulged  in,  say,  to 
about  one-half  the  estimated  thickness  of  the  sole.  Soften- 
ing of  the  horn  and  consequent  lessening  of  pressure  may 
then  be  brought  about  by  the  use  of  oil,  oil  and  glycerine, 
tincture  of  creasote,  or  by  poulticing. 

In  the  case  of  a  moist  corn  the  paring  should  be  stopped 
immediately  the  true  nature  of  the  injury  has  made  itself 
apparent.  Warm  poultices  or  hot  baths  should  then  be 
used  in  order  to  soften  the  surrounding  parts,  lessen  the 
pressure,  and  ease  the  pain.  After  a  day  or  two  day's 
poulticing,  should  pain  still  continue  with  any  symptom  of 


DISEASES  FROM  FAULTY  CONFORMATION  199 

severity,  the  formation  of  pus  may  be  expected,  and  it  is 
then  time  for  the  paring  to  be  carried  further,  until  the 
question  '  pus  or  no  pus  ?  '  is  definitely  settled. 

Should  the  moisture  be  due  simply  to  the  presence  of 
the  inflammatory  exudate,  then  poulticing  alone  will 
have  the  desired  effect,  and  the  pain  will  be  lessened. 
With  the  decrease  in  pain  the  poulticing  may  be  dis- 
continued, and  the  horn  over  the  seat  of  the  injury 
dressed  with  some  antiseptic  and  hardening  solution. 
Sulphate  of  zinc,  a  mixture  of  sulphate  of  zinc  and  lead 
acetate,  sulphate  of  copper,  or  the  mixture  known  as 
Yillate's  solution,*  may  either  of  them  be  used.  Suitably 
shod,  and  with  a  leather  sole  for  preference,  the  animal 
may  then  again  be  put  to  work. 

When  dealing  with  suppurating  corn,  then,  a  consider- 
able paring  away  of  the  horn  of  the  sole  becomes  a  matter 
of  necessity.  The  freest  possible  exit  should  be  given  to 
the  pus,  and  this  even  when  an  opening  has  already 
occurred  at  the  coronet.  Unless  this  is  done,  and  done 
promptly,  the  putrescent  matter  still  contained  within  the 
hoof  will  make  further  inroads  upon  the  soft  structures 
therein,  and  later  upon  the  ligaments,  and  even  bone  itself. 

Having  given  drainage  to  the  lesion  by  the  dependent 
orifice  in  the  sole,  poulticing  should  again  be  resorted  to, 
and  maintained  for  at  least  three  or  four  days.  The 
poulticing  may  then  be  discontinued,  and  the  openings  in 
the  sole  injected  with  a  weak  solution  of  Tuson's  spts. 
hydrarg.  perchlor.,  a  1  in  20  solution  of  carbolic  acid,  a 
solution  of  copper  sulphate,  with  Yillate's  solution,  or  with 
any  other  combined  antiseptic  and  astringent.  The  success 
of  the  treatment  is  soon  seen  in  the  cessation  of  pain  and 

*  The  composition  of  the  escarotic  liquid  bearing  his  name 
was  published  by  M.  Villate  in   1829  as  under: 

Subacetate  of  lead  liquid 128  grammes 

Sulphate    of    zinc 64  grammes 

Sulphate   of   copper 64  grammes 

Acetic  acid   */>  litre 

Dissolve  the  salts  in  the  acid,  add  little  by  little  the  subacetate 
of  lead,  and  well  shake  the  mixture. 


200        DISEASES  OF  THE  HORSE'S  FOOT 

in  the  decreased  amount  of  discharge  from  the  opening  in 
the  sole. 

Should  pain  unfortunately  continue,  the  discharge  re- 
main, and  a  state  of  fever  reveal  itself,  then  it  may  be 
understood  that  the  suppurative  process  has  not  been 
checked,  that  a  portion  of  necrosed  ligament,  cartilage,  or 
bone  still  remains,  which,  surrounded  as  it  is  by  pus 
organisms  and  putrefactive  germs,  is  sufficient  to  excite  a 
constant  irritation  and  maintain  the  internal  structures  in 
a  state  of  infection.  In  other  words,  we  have  what  is  known 
as  a  quittor. 

This  will  call  for  deeper  operation.  The  horn  of  the 
wall  must  be  removed,  and  the  diseased  structures,  whether 
gangrenous  keratogenous  membrane,  necrosed  ligament,  or 
carious  bone,  carefully  excised  or  curetted.  This  will  be 
better  understood  by  a  reference  to  the  chapter  on  Quittor,' 
where  the  means  for  carrying  out  the  necessary  operative 
measures  will  be  found  described  in  detail. 

Surgical  Shoeing  for  Corn. — In  the  case  of  an  ordinary 
dry  corn,  where  the  injury  has  been  definitely  ascertained 
to  be  accidental,  no  alteration  in  the  shoeing  will  be  neces- 
sary. Where,  however,  the  corn  is  attended  with  a  more 
than  ordinary  degree  of  inflammation,  or  where  for  some 
reason  or  other  excessive  paring  has  been  practised,  then 
it  will  become  needful  to  shoe  with  a  special  shoe.  The 
object  to  be  attained  is  the  removal  of  pressure  from  that 
portion  of  the  wall  next  to  the  seat  of  corn. 

The  most  simple  shoe  for  effecting  this  is  the  ordinary 
three-quarter  shoe.  The  only  way  in  which  this  differs 
from  the  ordinary  shoe  is  that  about  an  inch  and  a  half  of 
that  branch  of  the  shoe  adjoining  the  corn  is  cut  off 
(Fig.  102).  If  at  the  same  time  contraction  of  the  heels 
exists,  then,  perhaps,  a  better  shoe  is  that  known  as  the 
three-quarter  bar  (Fig.  103). 

Or,  if  preferred,  a  complete  bar  shoe  such  as  that 
described  for  sand-crack  may  be  used,  and  the  upper 
portion  of  the  web  in  contact  with  the  foot  at  the  seat  of 
corn  thinned  out  so  as  to  avoid  pressure  on  the  wall  at  this 


DISEASES  FROM  FAULTY  CONFORMATION  201 

point.  With  this  shoe  we  shall  at  the  same  time  supply  a 
certain  amount  of  pressure  to  the  frog,  and  aid  in  the' 
healthy  development  of  the  part  indirectly  involved  in  the 
disease. 

The  same  pressure  may  also  be  given  to  the  frog,  and 
protection  afforded  the  sole,  by  the  use  of  a  leather  sole,  or 
rubber  pad  on  leather,  as  described  when  dealing  with  con- 
tracted feet. 

A  further  method  of  relieving  pressure  on  this  portion  of 
the  wall,  without  removing  the  wall  itself  (a  practice  which 
should  never  be  advised)  is  to  make  certain  alterations  in 
the  web  of  the  shoe.  This  may  be  done  in  one  of  two 
ways. 


Fig.  102.— Three-quarter  Fig.  103.— Three-quarter 

Shoe.  Bar  Shoe. 

In  the  first,  that  portion  of  the  bearing  surface  of  the 
heel  of  the  shoe  is  '  dropped  '  about  -J  inch  from  the  plane  of 
the  remainder,  so  that  the  shoe  at  this  position  does  not 
come  in  contact  with  the  foot  at  all  (see  Fig.  104). 

In  the  second  case  the  shoe  is  what  is  termed  '  set '  at 
the  heel.  Here  it  is  the  plane  of  the  wearing  surface  of  the 
shoe  that  is  altered.  The  hinder  portion  of  the  required 
heel  is  thinned  so  that  its  lower  surface  does  not  come  into 
contact  with  the  ground.  By  this  means  the  wall  is  freed 
from  concussion  and  pressure.  At  the  same  time  the 
upper  surface  of  the  shoe  is  in  contact  with  the  wall  of  the 
foot  (see  Fig.  105). 

This  '  setting  '  of  the  shoe  is  preferable  to  the  method 
first  described.     It  affords  a  greater  protection  to  the  foot, 


?02 


DISEASES  OF  THE  HORSE'S  FOOT 


and  does  not  allow  of  fragments  of  stone  and  flint  getting 
in  between  the  foot  and  the  shoe,  and  so  giving  rise  to 
further  mischief. 

The  '  set '  portion  should  be  fitted  full  and  long.     It  is 


Fig.  104.— Shoe  with  a  'Dropped'  Heel. 

obvious,  too,  that  the  animal  should  not  be  allowed  to  carry 
the  shoe  too  long;  otherwise,  as  the  other  portion  of  the 
shoe  wears  down  to  the  level  of  the  '  set '  heel,  pressure  on 
the  tender  part  of  the  foot  will  again  result. 


Fig.   105.— Shoe  with  a  'Set'  Heel. 


In  applying  surgical  shoes  for  corn  of  long  standing,  it 
must  be  remembered  that  the  protection  so  afforded  must 
be  continued  for  some  time.  It  is  not  sufficient  to  see  the 
lesion  itself  disappear.     In  addition  to  that  there  is  also,  in 


DISEASES  FROM  FAULTY  CONFORMATION  203 

the  majority  of  cases,  a  certain  amount  of  contraction  to  be 
overcome.  This  can  only  be  done  by  continuing  the  use  of 
a  leather  sole  or  some  form  of  frog  or  bar-pad  as  recom- 
mended for  the  relief  of  that  condition. 

C.    CHRONIC  BRUISED  SOLE. 

A  similar  condition  to  that  of  corn  may  be  met  with  in 
other  positions  on  the  sole.  It  is  described  by  Rogerson 
as  sand-crack  of  the  sole,*  and  is  invariably  met  with 
around  that  portion  of  the  sole  in  contact  with  the  shoe. 

The  animal  is  lame,  and  the  shoe  is  removed  in  order  to 
ascertain  the  cause.  Nothing  at  first  is  noticeable  except 
that  the  animal  flinches  when  pressure  is  applied  to  the 
spot  with  the  pincers,  or  the  sole  is  tapped  with  the 
hammer. 

On  removing  the  sole  with  the  knife,  however,  a  distinct 
black  mark  is  discovered,  which,  when  followed  up  by 
careful  paring,  is  often  found  to  have  pus  at  the  bottom. 

In  this  case  the  injury  has  resulted,  as  we  have  already 
intimated  elsewhere,  from  causing  the  animal  to  wear  for 
too  long  a  time  a  shoe  with  too  broad  a  web  or  insufficiently 
seated.  Or  it  may  have  originated  with  the  irritation  set 
up  by  foreign  and  hard  substances  between  the  web  of  the 
shoe  and  the  foot. 

In  his  description  of  this  condition  Mr.  Rogerson  draws 
attention  to  the  fact  that  the  pus  found  should  not  be 
wrongly  attributed  to  accidental  pricking  of  the  foot.  He 
says : 

'  Considering  that  the  cracks  or  splits  are  always  found 
in  the  immediate  vicinity  of  the  nail  holes,  a  certain 
amount  of  discretionary  skill  is  required  in  order  that  the 
lameness  may  be  attributed  to  its  proper  cause.  This  is  an 
instance  in  wThich  the  presence  of  the  veterinary  surgeon  is 
imperative,  in  order  to  prevent  undue  blame  being  attached 
to  the  shoeing-smith.  Misconception  in  these  cases  might 
very  easily  arise  when  parties   concerned  are  disposed  to 

*    Veterinarian,  vol.   lxii.,   p.    51. 


204         DISEASES  OF  THE  HORSE'S  FOOT 

accept;  an  unskilled  opinion,  sometimes  resulting  in  danger 
to  the  proprietor  of  the  forge,  not  only  of  losing  a  shoeing 
contract,  but  also  of  being  involved  in  other  ways  which 
would  probably  prove  even  more  disastrous.' 

'  Horses  that  stand  on  sawdust  or  moss  litter  are  some- 
times found  with  extensive  discoloration  of  the  horny  sole 
in  front  of  the  frog.  Their  bedding  material  collects  in  the 
shoe  as  snow  does,  and  forms  a  mass,  which  keeps  a  con- 
tinued and  uneven  pressure  upon  the  sole.  A  sound  foot  is 
not  injuriously  affected,  but  a  very  thin  sole  is,  and  so  also 
is  a  sole  which  has  been  bruised  by  a  picked  up  stone. 
Even  a  slight  bruise  becomes  serious  if  pressure  is  allowed 
to  remain  active  over  the  injured  part.  Lameness  increases, 
serous  fluid  is  effused  between  the  horn  and  sensitive  part, 
or  even  haemorrhage  may  take  place.'  * 

The  Treatment  of  Chronic  Bruised  Sole  offers  no  special 
difficulty.  Removal  of  the  cause  (in  nearly  every  case 
incorrect  bearing  of  the  shoe)  is  the  first  consideration. 
That  done,  the  lesion  may  be  searched  for  and  treated  in 
the  ordinary  manner  as  described  for  corn.  When  pus  is 
present  it  must,  of  course,  be  given  exit,  and  an  antiseptic 
solution  applied  to  the  wound.  Should  the  sensitive 
structures  be  laid  bare  when  allowing  the  pus  to  escape, 
then  the  wound  so  made  should  afterwards  be  protected 
with  a  leather  sole  and  antiseptic  stopping. 

*   Hunting,   Veterinary  Record,  vol.  xiv.,  p.   593. 


CHAPTER  VIII 

WOUNDS  OF  THE  KERATOGENOUS  MEMBRANE 

A.    X AIL-BOUND— BIND  OR  TIGHT  NAILING. 

Definition. — By  the  term  '  nail-bound  '  is  indicated  that 
accident  occurring  in  the  forge  in  which  the  nail  of  the 
shoe  is  driven  too  near  the  sensitive  structures.  Although 
involving  no  actual  wound,  it  is  important  to  consider  the 
condition  under  the  heading  of  this  chapter,  in  order  that 
it  may  be  distinguished  from  the  graver  accident  of  a 
'  prick.' 

Causes. — Very  largely  the  whole  matter  of  causation  turns 
011  the  correct  fitting  of  the  shoe.  The  points  especially 
to  be  noticed  in  this  connection  are  (1)  the  position  of 
the  nail-holes  in  the  web  of  the  shoe,  (2)  the  'pitch'  of 
the  nail-holes. 

Regarding  the  position  of  the  nails,  it  goes  without  say- 
ing that  the  first  consideration  when  '  holing '  the  shoe 
should  be  to  punch  the  holes  opposite  to  sound  horn.  This 
romark  applies  especially  to  shelly  and  brittle  feet,  the  type 
of  feet  in  which  tight-nailing  most  often  occurs.  The  next 
consideration  in  this  connection  is  that  of  punching  the 
holes  so  that  the  nail  emerges  from  the  upper  surface  of 
the  web  at  exactly  its  correct  point  of  entrance  on  the  bear- 
ing surface  of  the  foot.  This  should  be  on  the  white  line 
immediately  where  it  joins  the  wall.  From  this  position 
any  marked  deviation  inwards  ( 'fine-nailing,'  as  it  is 
termed)  is  bound  to  give  to  the  nail  a  direction  dangerously 
near  the  sensitive  structures. 

205 


206        DISEASES  OF  THE  HORSE'S  FOOT 

The  '  pitch  '  of  the  nail-holes  should  be  such  that  the 
nail  is  guided  more  or  less  nearly  to  follow  the  line  of 
inclination  of  the  wall.  Accordingly,  the  nail-holes  at  the 
toe  should  be  '  pitched  '  distinctly  inwards,  the  inward  pitch 
lesssening  as  the  quarters  are  reached,  until  the  hindermost 
nail-hole  or  two  is  pitched  in  a  direction  that  is  almost 
perpendicular. 

Too  great  an  inward  inclination  of  the  nail  will,  however, 
give  rise  to  a  bind. 

It  is  probable  that  '  tight-nailing '  results  more  often 
from  fine  punching  of  the  shoe  than  from  any  fault  in  the 
pitch  of  the  hole.  Inattention  to  either  detail,  however,  is 
apt  to  bring  the  mischief  about. 

Even  with  a  correctly  fitted  shoe,  and  with  a  normal 
foot,  tight-nailing  may  occur  as  a  result  of  sheer  careless- 
ness on  the  part  of  the  smith. 

Symptoms. — Possibly  the  animal  returns  from  the  forge 
sound.  It  is  on  the  following  day,  as  a  rule,  that  evidence 
of  the  injury  is  given  by  the  animal  coming  out  from  the 
stable  lame.  In  a  well-marked  case  the  foot  is  warmer  to 
the  hand  than  its  fellow,  and  percussion  over  the  wall  will 
sometimes  reveal  the  particular  nail  that  is  the  cause  of 
the  trouble.  Should  the  shoe  be  removed,  then  the  fact 
that  the  hole  the  nail  has  made  is  far  too  close  to  the  sole 
often  points  out  at  once  the  seat  of  the  mischief. 

Treatment. — As  to  whether  or  not  the  shoe  should  be 
removed  is  very  much  a  matter  for  careful  discretion  on 
the  part  of  the  veterinary  surgeon.  Where  the  foot  is 
shelly  and  brittle  even  a  good  smith  sometimes  finds  him- 
self unable  to  firmly  attach  the  shoe  without  verging  closely 
on  causing  the  condition  we  are  now  describing.  The 
author  has.  known  cases  where  animals  with  feet  of  this 
description  have  almost  invariably  returned  from  the  forge, 
or  rather  been  found  the  next  day,  with  a  suspicion  of  ten- 
derness. After  the  lapse  of  a  day  or  two  this  has  quite  often 
disappeared,  and  nothing  in  the  meantime  been  done  with 
the  foot.  Seeing,  therefore,  that  removal  and  refitting  of 
the  shoe  is  in  this  case  attended  with  risk  of  breaking  away 


WOUNDS  207 

portions  of  the  brittle  horn,  and  so  rendering  the  foot  in 
an  even  worse  condition  than  it  was  before,  it  is  policy  to 
decline  to  have  the  shoes  removed  unless  worse  symptoms 
make  their  appearance. 

In  coming  to  this  decision  the  veterinary  surgeon  must 
be  guided  by  noting  in  the  wall  the  points  of  exit  of  the 
nails.  Should  the  nail  adjoining  the  position  already  pro- 
nounced to  be  tender  have  come  out  at  a  higher  point  than 
the  others,  it  may  be  assumed  that  at  a  lower  position  in 
its  course  through  the  horn  it  has  gone  near  the  sensitive 
structures  without  actually  penetrating  the  horny  box,  and 
that  in  the  course  of  a  day  or  two  the  sensitive  structures 
involved  will  accommodate  themselves  to  the  pressure  thus 
inflicted. 

If,  on  the  other  hand,  symptoms  of  tight-nailing  show 
themselves  in  an  animal  with  good  sound  feet,  then  there? 
is  no  objection  to  be  raised  against  having  the  shoe  at  once 
removed.  Should  the  offending  nail  be  definitely  detected, 
then  the  shoe  may  again  be  put  on,  and  that  particular 
nail  omitted  from  the  set. 

B.    PUNCTUEED  FOOT. 
{Pricked  Foot — X all-tread — Gathered  Nail.) 

Definition. — Under  this  heading  we  propose  describing 
wounds  of  the  foot  occurring  in  the  sole  or  in  the  frog,  and 
penetrating  the  sensitive  structures  beneath. 

Causes. — These  we  shall  consider  under  two  headings : 

1.  Wounds  resulting  from  the  animal  himself  '  picking- 
up  '  or  '  treading '  on  the  offending  object. 

2.  Cases  of  pricking  in  the  forge. 

Those  occurring  under  the  first  heading  are,  of  course, 
purely  accidental.  In  the  majority  of  cases,  the  object 
picked  up  is  a  nail;  but  similar  injury  may  result  from  the 
animal  treading  on  sharp  pieces  of  wood  or  iron,  on  pieces 
of  umbrella  wire,  on  pointed  pieces  of  bones,  broken-off 
stable-fork  points,  sharp  pieces  of  flint,  etc.  The  same 
accident  may  also  occur  in  the   forge  as  a  result  of  the 


208        DISEASES  OF  THE  HORSE'S  FOOT 

animal  treading  on  the  stumps  of  nails,  from  treading 
on  an  upturned  shoe  with  the  stumps  of  nails  in  situ,  or 
from  treading  on  an  upturned  toe-clip.  It  may  also  occur 
from  an  accidental  prick  with  the  stable-fork  when  '  bed- 
ding up,'  or  from  casting  part  of  a  shoe  when  on  the  road 
and  treading  on  the  nails,  in  this  case  left  sometimes  partly 
in  and  partly  out  of  the  horn. 

'  Serious  wounds  of  this  description  are  also  met  with  in 
animals  engaged  in  carting  timber  from  plantations  in 
which  brushwood  has  recently  been  cut  down.  This  is, 
of  course,  from  treading  on  the  stake-like  points  that  are 
left  close  to  the  ground.  Hunters  also  meet  with  the  same 
class  of  injury  when  passing  through  plantations  or  over 
hedge  banks,  where  the  hedge  has  just  been  laid  low  or 
cut  down. 

'  Agricultural  horses  also  meet  with  severe  wounds  of 
this  class  from  treading  on  an  upturned  harrow.'* 

It  has  been  remarked  how  strange  it  is  that  nails  should 
so  readily  penetrate  the  comparatively  hard  covering  of  the 
foot.  The  matter,  however,  admits  of  explanation.  One 
knows  from  common  observation  how  easy  it  is  to  tilt  a 
nail  with  its  point  upwards  by  exerting  a  pressure  in  a 
more  or  less  slanting  direction  upon  its  head.  This  is 
exactly  the  form  of  pressure  that  is  no  doubt  put  upon  the 
nail  if  the  animal  treads  upon  it  when  moving  at  any  pace 
out  of  a  walk.  The  foot  in  its  movement  forward  tilts  the 
nail  up,  and  almost  simultaneously  puts  weight  upon  it. 
The  great  weight  of  the  animal  is  then  quite  sufficient  to 
account  for  its  ready  penetration. 

In  purely  country  districts  cases  of  punctured  foot  are  of 
far  less  frequent  occurrence  than  in  large  towns.  In  the 
latter,  animals  labouring  in  yards  where  a  quantity  of  pack- 
ing is  done,  or  engaged  in  carting  refuse  containing  such 
objects  as  we  have  mentioned,  or  broken  pieces  of  earthen- 
ware or  glass  bottles,  meet  with  it  constantly. 

For  the  manner  of  causation  of  those  wounds  to  the  foot 

*  Journal  of  Comparative  Pathology  and  Therapeutics,  vol.  iv., 
p.    2. 


WOUNDS  209 

occurring  in  the  forge  the  reader  may  be  referred  to  the 
matter  under  the  heading  of  '  nail-bound.'  As  in  that  case 
so  in  this  the  nail  may  be  wrongly  directed  by  improper 
fitting  of  the  shoe,  by  the  '  pitch  '  of  the  hole,  or  by  the 
position  of  the  hole.  The  nails  may  also  be  wrongly 
directed  as  a  result  of  faulty  pointing,  or  by  meeting  with 
the  stump  of  a  nail  that  has  carelesssly  been  allowed  to 
remain  in  the  substance  of  the  horn. 

Often  pricking  is  a  result  of  carelessness  engendered 
by  a  rush  of  work.  Often  it  is  almose  unavoidable  on 
account  of  the  character  of  the  foot  that  is  brought  to 
be  shod.  Feet  with  thin  horn,  especially  a  thin  sole,  feet 
with  horn  shelly  and  brittle,  each  in  their  way  are  difficult 
to  shoe. 

Sometimes  pricking  is  purely  accidental,  as  in  the  case 
o:r  a  '  split '  nail.  The  nail  as  it  is  driven  splits  at  its 
point,  and  continues  to  split  down  its  centre,  one  half 
emerging  at  the  correct  spot  on  the  wall,  the  other  half 
bending  inwards,  and  penetrating  the  sensitive  structures. 

Common  Situations  of  the  Wound. — In  a  case  of  picked- 
up  nail  the  common  seat  of  puncture  is  about  the  point  of  the 
frog,  either  in  one  of  the  lateral  lacunae,  in  the  median 
lacuna,  or  the  apex  of  the  frog  itself.  In  comparison  wTith 
this  puncture  of  the  sole  is  rare. 

Prick  sustained  at  the  hands  of  the  smith  may,  of  course, 
run  in  either  of  the  following  directions:  (1)  Directly  into 
the  position  where  the  horny  and  sensitive  laminae  inter- 
leave; (2)  between  the  sensitive  laminae  and  the  os  pedis; 
(3)  into  the  os  pedis  itself;  (4)  the  nail  may  bend  exces- 
sively immediately  after  entering  the  horn,  and  so  pass 
either  between  the  horny  and  sensitive  sole  :  or  (?)  between 
the  sensitive  sole  and  the  bone. 

Classification. — Punctured  wounds  of  the  foot  may  be 
classified  as  follows : 

Simple  or  superficial  when  penetrating  no  structure  of 
great  importance.  For  instance,  a  prick  that  penetrates  to 
the  sensitive  sole  and  is  not  driven  with  sufficient  force  to 
seriously  injure  the  os  pedis  we  may  regard  as  simple.     In 


210        DISEASES  OF  THE  HORSE'S  FOOT 

the  same  manner  a  prick  to  the  frog  that,  although  deep, 
is  mainly  concerned  with  penetrating  the  plantar  cushion 
may  also  be  classed  as  simple. 

Deep  or  penetrating  when  driven  with  sufficient  force  or 
in  such  a  direction  as  to  injure  structures  whose  penetra- 
tion is  calculated  to  give  rise  either  to  serious  constitutional 
disturbance  or  to  permanent  lameness.  In  this  category 
Ave  may  place  injuries  to  the  terminal  portion  of  the  per- 
forans,  puncture  of  the  navicular  bursa,  fracture  of  the 
navicular  bone  and  penetration  of  the  pedal  articulation, 
and  splintering  of  the  os  pedis. 

Symptoms  and  Diagnosis. — While  discussing  the  symp- 
toms and  diagnosis,  we  will  still  continue  to  consider  our 
subject  under  the  two  headings  of  (1)  accidental  'gather- 
ing' of  some  foreign  body,  and  (2)  pricks  inflicted  in  the 
forge. 

In  a  few  cases  belonging  to  the  former  class  the  veter- 
inary surgeon  is  fortunate  in  obtaining  a  direct  history  of 
the  injury.  The  driver  has  seen  the  animal  go  suddenly 
lame,  and  has  examined  the  foot  for  the  cause.  Either  the 
nail  has  been  found  embedded  in  the  horn,  or  the  puncture 
it  has  made  detected,  and  the  matter  has  been  reported. 
The  foot  is  then  explored  and  the  full  extent  of  the  injury 
ascertained. 

In  many  cases,  however,  it  so  happens  that  no  evidence 
of  the  infliction  of  the  injury  is  forthcoming.  The  momen- 
tary lameness  occurring  at  the  time  of  the  prick  is  unre- 
ported at  the  time  by  the  attendant,  and  the  horse  for  a  time 
goes  sound.  It  is  not  until  the  changes  set  up  by  the  sub- 
sequent inflammatory  phenomena  make  their  appearance, 
and  lameness  results,  that  attention  is  called  to  the  foot. 
When  this  happens  there  has,  as  a  rule,  been  time  for  pus  to 
form  around  the  seat  of  puncture — a  matter  of  about  forty- 
eight  hours. 

The  horse  is  now  brought  out  for  the  veterinary  sur- 
geon's examination,  going  distinctly  lame.  If  the  case  is 
well  marked  there  may  then  be  noted  by  the  man  of  ex- 
perience many  little   signs  pointing  to    the    foot    as    the 


WOUNDS  211 

seat  of  the  lameness.  These,  though  well  enough  known  to 
the  practitioner,  are  nevertheless  difficult  to  describe.  It  is, 
in  fact,  hard  to  say  exactly  in  what  they  really  consist, 
appearing  to  be  as  much  a  matter  of  intuition  as  of  actual 
observation. 

There  is  a  peculiar  '  feeling  '  characteristic  in  the  gait. 
The  affected  foot  is  put  forward  fearlessly  enough,  but  is 
not  nearly  so  rapidly  put  to  the  ground.  When  at  rest  the 
foot  is  almost  immediately  pointed,  and  the  pain  at  inter- 
vals manifested  by  pawing  movements.  It  is  this  extreme 
liberty  of  the  rest  of  the  limb,  as  evinced  during  the  paw- 
ing movements,  that  really  strikes  one.  Shoulder,  elbow, 
knee,  and  fetlock  are  all  easily  and  painlessly  flexed  and 
extended.  There  is  nothing  wrong  with  them ;  it  must  be 
the  foot.  The  short  manipulation  necessary  to  test  the 
lameness — viz.,  the  walk  and  slow  trot — is  sufficient  to  raise 
the  animal's  pulse  and  quicken  the  breathing. 

All  this  is  enough,  and  more  than  enough,  to  lead  the 
veterinary  surgeon  to  examine  the  foot.  It  is  hot  to  the 
touch,  and  at  the  coronet  tender  to  pressure,  possibly  in  a 
neglected  case  fluctuating  at  the  heel.  Pain  is  evinced  by 
the  animal  withdrawing  his  foot  when  percussion  takes 
place  over  the  affected  spot.  In  a  bad  case  one  gentle  tap 
is  all  that  is  needed.  The  animal  at  once  snatches  away 
his  foot,  holds  it  high  from  the  ground,  and  makes  pawing 
movements  in  the  air.  At  that  moment,  too,  his  coun- 
tenance is  highly  expressive  of  the  pain  he  is  suffering. 
Again  the  foot  is  explored,  the  injury  found,  and  the  pus 
liberated. 

Regarding  the  manner  of  exploration  of  the  foot  we  will 
take  first  that  case  in  which  the  veterinary  surgeon  is  called 
in  early,  and  in  which  pus  has  not  yet  had  time  to  form, 
Sometimes  the  merest  cleaning  up  of  the  inferior  surface 
of  the  foot  then  reveals  a  distinct  stab  either  in  the  sole  or 
the  frog. 

If  the  accident  be  recent  only  a  little  blood  will  be  found, 
either  liquid,  or  coagulated  about  the  wound.  Later  there 
exudes  from  the  stab  a  flow  of  yellow,  serous  fluid.     The 


212         DISEASES  OF  THE  HORSE'S  FOOT 

opening  thus  found  should  be  carefully  probed,  and  its 
depth  and  situation  noted. 

At  other  times  the  prick  is  not  so  readily  apparent.  The 
nail  or  other  object  has  penetrated  and  afterwards  with- 
drawn itself.  The  natural  elasticity  of  the  horn,  especially 
that  of  the  frog,  causes  it  to  contract  upon  the  puncture, 
and  to  largely  obliterate  the  hole  made.  What,  therefore, 
may  look  to  be  but  a  simple  injury  to  the  horn  alone  may 
in  reality  be  the  only  evidence  of  a  stab  complicating  the 
sensitive  structures.  It  thus  behoves  the  veterinary  sur- 
geon to  follow  up  and  carefully  cut  out  any  unnatural- 
looking  mark  in  the  horn,  more  especially  if  the  horn  is  dis- 
coloured, or  if  blood  is  extravasated  into  its  fibres,  or  there 
is  moisture  exuding  from  the  part. 

In  some  cases  of  this  description  the  knife  in  the  act  of 
paring  comes  into  contact  with  the  cause  of  the  trouble. 
Sometimes  this  is  a  nail,  sometimes  a  sharp  and  small 
piece  of  flint,  so  deeply  penetrated  as  to  have  become  quite 
buried.  When  met  with  in  this  manner,  however,  the 
foreign  body  is  more  often  than  not  a  splinter  of  wood 
deeply  embedded  in  the  cleft  of  the  frog  or  in  the  frog 
itself. 

The  fact  that  multiple  punctures  may  occur  should  here 
be  remembered,  and  the  remainder  of  the  inferior  surface 
of  the  foot  thinly  pared. 

On  withdrawal  of  the  foreign  object  blood  may  immedi- 
ately follow.  Should  the  former  have  been  fixed  in  position 
for  some  time,  however,  pus  is  nearly  always  found  at  the 
bottom  of  the  wound.  As  a  rule,  its  removal  is  compara- 
tively easy,  but  one  case  recalls  itself  to  the  author's  mind 
iii  which  the  extraction  was  a  matter  of  considerable  diffi- 
culty. The  offending  object  was  a  large,  flat-headed  nail, 
some  2  inches  long.  This  was  driven  fast  into  the  os  pedis, 
and  necessitated  the  employment  of  a  pair  of  pincers  and 
the  exertion  of  some  amount  of  force  to  move  it  from  its 
position. 

In  this  connection  it  must  be  remembered  that  the  pene- 
trating object  sometimes  breaks  off  after  entering  the  foot. 


WOUNDS  213 

The  fact  that  this  occasionally  happens  only  serves  to  give 
point  to  the  advice  we  have  previously  rendered — that  every 
stab  should  be  carefully  probed,  and  its  exact  condition  and 
depth  ascertained. 

In  those  cases  where  percussion  has  led  to  the  positive 
opinion  that  pus  really  exists,  then  the  exploration  must  be 
most  searching.  There  may,  or  may  not,  be  a  suspicious- 
looking  mark  to  work  on.  In  the  latter  case,  the  veterinary 
surgeon  must  not  be  content  with  confining  his  paring  opera- 
tions to  one  spot.  The  sole  should  be  carefully  thinned 
all  round,  and  the  thinning  cautiously  proceeded  with  until 
cither  small,  pin-point  haemorrhages  denote  that  healthy 
sensitive  structures  have  been  reached,  or  a  sudden  flow 
of  pus  indicates  that  the  injury  has  been  definitely 
located. 

While  the  symptoms  remain  much  about  the  same,  the 
diagnosis  of  pricks  received  in  the  forge,  as  compared  with 
those  occurring  in  the  natural  manner,  is  easy.  The 
animal  starts  to  the  forge  quite  sound,  and  returns,  per- 
haps, with  a  slight  limp.  The  slight  limp  in  two  days' 
time  becomes  a  decided  lameness,  and  no  doubt  remains 
as  to  what  has  occurred.  The  mere  fact  of  the  lameness 
arising  immediately  after  a  visit  to  the  forge  should  be 
sufficient  in  the  majority  of  cases  to  lead  one  to  a  correct 
diagnosis. 

\\  nere  the  opinion  has  been  formed  that  a  prick  has  been 
received,  then  the  shoe  should  be  removed. 

This  operation  should  always  be  superintended  by  the 
veterinary  surgeon  himself  After  the  removal  of  the 
clinches,  the  nails  should  be  drawn  one  at  a  time  with  the 
pincers,  and  carefully  examined.  Often  the  offending  nail 
may  thus  be  picked  out  by  observing  upon  it  blood-stains, 
or  the  moisture  from  inflammatory  exudate  or  from  pus. 
Further  inflammation  will  also  be  gathered  by  occasionallv 
meeting  with  a  nail  that  has  split. 

At  this  stage,  too,  the  veterinary  surgeon  should  have 
noticed  whether  or  not  the  smith  has  previously  sent  the 
animal  home  with  what  is  known  as  a  '  draw  back.'     He 


214        DISEASES  OF  THE  HORSE'S  FOOT 

has  discovered,  immediately  after  he  has  done  it,  that  he 
has  pricked  the  animal.  He  has  then  withdrawn  the  nail, 
and  either  sent  the  animal  back  with  that  nail  altogether 
missing  from  the  set  in  the  shoe,  or  with  the  hole  filled  up 
with  a  stump. 

The  shoe  once  off,  the  hole  made  by  the  nail  in  the 
horn  should  be  minutely  examined  for  the  presence  of 
hemorrhage,  inflammatory  fluid,  or  pus  exuding  from 
them,  and  also  for  evidence  of  their  correct  placing  in  the 
foot.  Should  fluid  matter  issue  from  any  one  of  them,  or 
should  it  be  deemed  that  one  has  approached  too  near  the 
inner  margin  of  the  white  line,  more  especially  if  tender- 
ness exists  around  it,  that  hole  should  be  followed  up 
with  a  '  searcher  '  or  small  drawing-knife  until  diagnosis  is 
certain. 

Complications. — Before  proceeding  to  discuss  the  com- 
plications that  may  arise  in  the  case  of  pricked  foot,  we 
may  call  to  mind  that  the  anatomy  of  the  parts  teaches  us 
that  the  most  serious  position  in  which  a  punctured  wound 
can  occur  is  at  the  center  of  the  foot.  Here  the  plantar 
aponeurosis,  the  navicular  bursa,  the  navicular  bone  itself, 
or  the  pedal  articulation  may  be  injured. 

Anterior  to  this  position  the  most  serious  mischief  that 
c^n  ordinarily  result  is  stabbing  of  the  os  pedis. 

Posterior  to  the  position  we  have  named,  the  only  struc- 
ture to  be  injured  is  the  plantar  cushion. 

Anatomically,  then,  the  inferior  surface  of  the  foot  may 
be  divided  into  three  zones,  as  follows : 

A.  Anterior,  extending  from  the  toe  to  the  point  of  the 
frog. 

B.  Middle,  extending  from  the  point  of  the  frog  to  the 
commencement  of  its  median  lacuna. 

C.  Posterior,  including  everything  posterior  to  the  mid- 
dle zone. 

This  division  of  the  inferior  surface  of  the  foot  into 
zones  will  be  somewhat  of  a  guide  also  when  describing 
the  complications  next  to  follow : 

(a)     Suppuration. — This  is  the  common  complication  of 


WOUNDS  215 

most  wounds  of  the  foot.  When  detected,  it  calls  for 
immediate  surgical  interference  in  the  shape  of  removal 
of  the  horn  of  the  sole  or  the  frog,  as  the  case  may  be. 
This  we  shall  consider  further  under  the  treatment. 

(b)  Separation  of  the  Homy  Frog. — This  is  a  sequel  to 
pus  formation  in  the  sensitive  structures  immediately  be- 
neath it,  and  the  condition  makes  itself  apparent  by  a  line 
of  separation  between  the  horn  and  the  skin  of  the  heel  of 
the  injured  side. 

(c)  Wounding  of  the  Plantar  Aponeurosis. — This  occurs 
when  a  moderately-deep  penetration  of  the  horn  of  the 
middle  zone  has  taken  place.  It  is  always  most  painful, 
especially  when  complicated  by  necrosis.  The  heels  is 
then  persistently  elevated,  and  lameness  is  extreme,  in 
some  cases  so  severe  as  to  cause  the  leg  to  be  carried  alto- 
gether. 

In  favourable  cases  the  necrosed  piece  of  tendon  is 
sloughed  off  by  the  process  of  suppuration,  and  escapes 
with  the  discharges  from  the  wound.  There  is  then  an 
abatement  in  the  symptoms,  and  recovery  is  rapid. 

Commonly,  however,  on  account  of  the  non-vascularity 
of  the  structure  of  the  tendon,  the  necrotic  spot  in  it  tends 
to  spread.  The  wound  is  thus  led  to  become  fistulous  in 
character,  and  the  pus  forming  within  it  prevented  from 
escaping  from  the  original  opening.  As  a  result,  lameness 
and  fever  persist.  There  is  a  gradual  increase  in  the 
severity  of  the  symptoms,  and  later  fistulous  openings 
appear  in  the  hollow  of  the  heel. 

(d)  Puncture  of  the  Navicular  Bursa. — This  results  from 
a  prick  in  exactly  the  same  position  as  that  last  described, 
and  means  that  the  penetrating  object  has  gone  deeper.  It 
may  be  distinguished  from  puncture  of  the  plantar  aponeu- 
rosis alone  by  the  fact  that  there  is  an  excessive  discharge 
of  synovia  from  the  wound.  This,  as  it  escapes,  is  at  first 
clear  and  straw-coloured.  Later  it  becomes  cloudy  and 
flaked  with  pus,  and  shows  a  tendency  to  coagulate  in  yel- 
lowish clots. 

Pain    and    accompanying    fever    is    most    marked,    much 


216        DISEASES  OF  THE  HORSE'S  FOOT 

more  so  than  when  the  plantar  aponeurosis  alone  is  in- 
jured. 

Should  the  original  wound  be  insufficiently  enlarged,  or 
should  its  opening  become  occluded  by  the  solid  matters  of 
the  discharge,  then  this  condition,  like  the  last,  ends  in  the 
formation  of  fistulous  openings  in  the  heel.  These  make 
tneir  appearance  as  hot,  painful,  and  fluctuating  swellings 
in  that  position.  Later  they  break,  discharge  their  con- 
tents, and  leave  a  fistulous  track  behind. 

(e)  Fracture  of  the  Navicular  Bone. — Penetration  of  the 
substance  of  the  navicular  bone,  without  its  fracture,  adds 
nothing  to  the  symptoms  we  have  described  under  puncture 
of  the  bursa.  That  the  bone  has  been  reached  by  the 
penetrating  object  may  be  detected  by  probing.  This,  how- 
ever, must  be  performed  with  care,  especially  if  a  flow 
of  synovia  is  absent.  Otherwise,  the  wound,  as  yet,  per- 
haps, superficial  enough  to  avoid  penetrating  even  the  bursa, 
is  made  a  penetrating  one  by  the  probe  itself. 

Fracture  of  the  navicular  bone  is  fortunately  rare. 

(/)  Penetration  of  the  Pedal  Articulation  and  Arthritis. 
— This  we  shall  consider  in  greater  detail  in  Chapter  XII. 
Ic  is  sufficient  here  to  state  that  the  condition  may  be  sus- 
pected when  a  hot  and  painful  swelling  of  the  whole  coronet 
makes  its  appearance.  There  is  at  the  same  time  a  diffused 
cedema  of  the  fetlock  and  the  region  of  the  cannon,  some- 
times extending  upwards  to  the  whole  of  the  limb. 

Of  all  the  complications  to  be  met  with  in  punctured  foot 
this  is  the  one  most  to  be  dreaded.  The  intense  pain  and 
the  high  fever  render  the  animal  weak  and  thin  in  the  ex- 
treme. The  appetite  becomes  impaired,  sometimes  alto- 
gether lost,  and  the  patient  in  many  cases  appears  to  die 
from  sheer  exhaustion.  Added  to  this  is  always  the  ex- 
treme probability  of  the  wound  becoming  purulent,  and  later 
the  dread  of  general  septic  infection  of  the  blood-stream 
ensuing,  and  death  resulting  from  that.  Even  with  the 
happier  ending  of  resolution,  anchylosis  of  the  joint 
and  incurable  lameness  is  more  often  than  not  left  behind. 
(See  Suppurative  or  Purulent  Arthritis,  Chapter  XII.) 


WOUNDS  217 

(g)  Ostitis  and  Caries  of  the  Os  Pedis. — Injuries  to  the 
os  pedis  are  met  with  in  the  anterior  zone  of  the  foot. 
Evidence  that  the  bone  has  been  injured  is  not  usually 
forthcoming  until  after  the  lapse  of  some  days.  One  is 
led  to  suspect  it  by  the  fact  that  there  is  no  indication  of 
the  suppurative  process  extending  further  upwards,  coupled 
with  the  facts  that  great  pain,  high  fever,  and  extreme 
lameness  persist,  and  that  there  is  a  continuous  discharge 
fiom  the  wound  of  a  copious  blood-stained  and  foetid  pus. 
Used  now,  the  probe  reveals  the  fact  that  the  bone  is  bared, 
and  conveys  to  the  hand  that  is  holding  it  a  sensation  of 
crumbling  fragility. 

(h)  Wounding  of  the  Lateral  Cartilage  and  Quittor. — 
This  occurs  as  the  result  of  a  deep  stab  in  the  posterior 
zone.  Ordinarily,  wounds  in  this  position  are  unattended 
with  serious  consequences,  and  the  prick  has  to  be  a  deep 
and  a  severe  one  before  the  cartilage  is  reached.  What 
then  happens  is  that  a  spot  of  necrosis  is  formed  round  the 
seat  of  puncture  in  the  cartilage.  This,  unless  met  with 
surgical  interference,  is  sufficient  to  maintain  the  wound  in 
a  septic  condition ;  it  takes  on  a  fistulous  character,  and  a 
quittor  is  formed.     (See  Chapter  X.) 

(i)  Septic  Infection  of  the  Limb. — This  we  have  already 
once  or  twice  referred  to.  It  simply  means  that  the  septic 
matters  from  the  wound  have  gained  the  lymphatics,  and 
finally  the  blood-vessels  of  the  limb,  and  set  up  local 
lesions  elsewhere  than  in  the  foot.  Although  dismissed 
here  with  these  few  words,  the  condition  is  a  most  serious 
one.  Usually,  it  has  resulted  from  penetration  of  the  pedal 
articulation  and  septic  infection  of  the  joint.  In  the  vast 
majority  of  these  cases  slaughter  is  both  humane  and 
economical. 

Prognosis. — The  first  consideration  in  giving  a  prognosis 
in  punctured  foot  should  be  the  position  of  the  wound. 
When  occurring  in  the  middle  zone,  the  surgeon's  state- 
ments should  be  most  guarded,  and  the  dangers  attending 
a  wound  in  that  particular  position  fully  explained  to  the 
owner.     A  wound  in  the  anterior  position  is,  as  we  have 


218        DISEASES  OF  THE  HORSE'S  FOOT 

said,  far  less  serious,  and  one  in  the  posterior  region  of  the 
foot  even  less  serious  still. 

Whenever  possible,  the  nail  or  other  object  causing  the 
prick  should  be  examined.  Much  of  the  prognosis  may  be 
based  upon  the  estimated  depth  of  the  wound,  and  this,  in 
many  cases,  it  is  far  safer  to  calculate  from  the  length  of 
the  offending  body  than  from  the  use  of  the  probe.  We 
need  hardly  say  that  in  the  middle  zone  the  deeper  the 
prick,  the  more  serious  the  case,  and  the  less  favourable 
the  prognosis.  As  in  succession  the  sensitive  sole,  the 
plantar  aponeurosis,  the  navicular  bursa,  the  navicular 
bone,  or  the  pedal  articulation  is  injured,  so  with  each  step 
deeper  of  the  prick  is  the  severity  of  the  case  increased. 

The  shape  of  the  penetrating  object  may  also  be  con- 
sidered. One  excessively  blunt,  and  calculated  to  bruise 
and  crush  the  tissues,  will  inflict  a  more  serious  wound 
than  one  of  equal  length  that  is  pointed  and  sharp. 

The  conformation  of  the  foot  should  also  be  regarded. 
Wounds  in  well-shaped  feet  are  less  serious  than  in  feet 
with  soles  that  are  flat  or  convex,  or  in  which  the  horn  is 
pumiced  or  otherwise  deteriorated  in  quality. 

Although  unaffecting  the  prognosis  so  far  as  the  actual 
termination  of  the  case  is  concerned,  it  may  be  mentioned 
that  punctured  foot  is  far  more  serious  in  a  nag  than  in  a 
heavy  draught  animal.  With  an  equal  degree  of  lameness 
resulting  in  each  case,  the  former  will  be  well-nigh  useless^ 
but  the  latter  still  capable  of  performing  much  of  his  usual 
labour. 

The  temperament  and  conditions  of  the  patient  will  also 
in  many  cases  largely  influence  the  prognosis.  An  animal 
of  excitable  and  nervous  disposition  is  far  more  likely  to 
succumb  to  the  effects  of  pain  and  exhaustion  than  the 
horse  of  a  more  lymphatic  type.  In  the  case  of  a  patient 
suffering  from  a  prick  to  a  hind- foot  while  heavily  pregnant, 
the  attempted  forecast  of  the  termination  should  be  cautious. 
More  especially  does  this  apply  to  the  case  of  a  heavy  cart- 
mare.  Ordinarily,  the  heavier  the  breed,  the  greater  the 
tendency  to  lymphatic  swelling  of  the  hind-limbs.       With 


WOUNDS  219 

pregnancy  this  tendency  is  enormously  increased,  and  it  is 
no  uncommon  thing  to  find  a  cart-mare  in  this  condition, 
with  legs,  as  the  owner  terms  it,  '  as  thick  as  gate-posts.' 
A  prick  to  the  foot,  with  the  lymphatics  of  the  limb  in  this 
state,  is  extremely  likely  to  end  in  septic  infection  of  the 
leg,  for  there  appears  to  be  no  doubt  but  that  invasion  of 
the  lymphatics  with  septic  matter  is  favoured  by  a  sluggish 
stream.  Also,  in  the  case  of  a  patient  in  the  advanced 
stages  of  pregnancy,  it  must  be  remembered  that,  no  matter 
how  great  may  be  the  need,  one  is  debarred,  for  obvious 
reasons,  from  using  the  slings. 

Treatment. — In  a  simple  case — and  by  '  simple  '  here  we 
mean  the  case  in  which  the  injury  is  disco verd  early,  and 
pus  has  not  yet  commenced  to  form — our  first  duties  are  to 
give  the  wound  free  drainage,  and  to  maintain  it  in  an 
aseptic  condition.  The  first  of  these  objects  is  to  be  arrived 
at  by  paring  down  the  horn  in  a  funnel-shaped  fashion 
over  the  seat  of  the  prick.  It  is,  perhaps,  even  better  to 
thin  the  horn  down  to  the  sensitive  structures  for  some 
little  distance  round  the  injury.  By  this  latter  method 
pressure  from  inflammatory  exudate  is  lessened,  and  the 
after-formation  of  pus,  if  unfortunate  enough  to  occur,  the 
more  readily  detected,  and  the  less  likely  to  spread  upwards. 
The  matter  of  asepsis  may  then  be  attended  to. 

When  the  puncture  is  sufficiently  large  to  admit  of  it,  the 
antiseptic  dressing  is  best  applied  by  means  of  the  probe. 
This  instrument  is  thinly  wrapped  with  tow,  or  other 
absorbent  material,  so  as  to  form  a  small  swab.  Dipped  in 
a  suitable  solution  (as,  for  example,  Zinc  Chloride,  Spts. 
Hydrarg.  Perchlor.,  Carbolic  Acid,  or  any  other  that 
suggests  itself,)  the  swab  is  inserted  into  the  prick,  and  the 
wound  conveniently  mopped  clean.  A  further  portion  of 
the  medicated  tow  is  then  pushed  partially  into  the  wound, 
and  allowed  to  remain  in  position.  The  foot  is  subsequently 
wrapped  in  a  clean  bag,  and  kept  free  from  dirt.  This 
dressing  should  be  repeated  twice  daily. 

If  the  prick  is  in  a  dangerous  position,  and  deep  enough 
to  occasion  alarm,  our  precautions  to  prevent  the  formation 


220        DISEASES  OF  THE  HORSES  FOOT 

of  septic  matters  within  it  may  be  more  elaborate.  The 
thinning  of  the  horn  and  the  swabbing  of  the  wound  may, 
as  before,  be  proceeded  with.  In  addition,  the  whole  foot 
may  then  be  immersed  for  some  hours  daily  in  a  cold  bath, 
which  bath  should  be  strongly  impregnated  with  one  or 
other  of  the  following  salts :  Iron  Sulphate,  Zinc  Sulphate, 
Copper  Sulphate,  Aluminium  Sulphate,  Lead  Acetate,  or 
Sodium  Chloride — better  still,  a  mixture  of  the  various 
sulphates  here  mentioned.  If  preferred,  one  of  the  more 
commonly  accepted  antiseptics — such  as  Carbolic  Acid, 
Lysol,  Boracic  Acid,  or  Perchloride  of  Mercury — may  be 
substituted. 

By  the  cold  of  the  bath  inflammatory  phenomena  are 
held  in  check,  while  its  added  antiseptic  prevents  the 
formation  of  septic  discharges.  The  lameness  gradually 
diminishes,  and  resolution  is  rapid.  In  this  way  deep  and 
serious  wounds  are  sometimes  easily  and  successfully 
treated. 

When  suppuration  has  occurred — and  this,  by-the-by,  is 
by  far  the  most  frequent  condition  in  which  we  find  punc- 
tured foot — treatment  must  be  prompt  and  decided.  Care- 
ful search  must  at  once  be  made  by  thinning  down  the 
sole,  and  carefully  trimming  the  frog.  On  no  account 
should  the  veterinary  attendant  rest  content  with  '  digging  ' 
in  one  place,  and  upon  that  basing  a  negative  opinion  as  to 
the  existence  of  pus.  The  paring  should  be  carried  on, 
until  either  pus  or  haemorrhage  shows  itself,  in  at  least  three 
positions — namely,  at  the  most  anterior  portion  of  the  sole, 
and  in  the  sole  at  each  side  of  the  frog.  In  addition  to 
this,  the  frog  itself  should  be  minutely  examined  for  evi- 
dence or  puncture,  or  for  leaking  of  pus  at  the  spot  where 
the  horn  of  the  heels  joins  the  skin. 

In  many  of  our  cases,  however,  this  careful  search  is  not 
so  necessary.  The  accompanying  symptoms  are  so  decided 
as  to  leave  no  doubt  as  to  the  condition  of  the  case.  In 
such  instances  paring  may  often  be  commenced  over  the 
exact  position  of  suppuration  as  previously  ascertained  by 
percussion. 


WOUNDS  221 

When  met  with,  the  track  formed  by  the  suppurative 
process  should  be  followed  up  in  whichever  direction  it 
has  spread.  This  will  often  necessitate  the  removal  of 
the  greater  part,  if  not  the  whole,  of  the  horny  sole. 

Having  given  vent  to  the  pus.  and  opened  up  the  cavity 
made  by  its  formation,  the  foot  should  be  placed  in  a  hot 
poultice  or,  preferably,  in  a  hot  antiseptic  bath.* 

At  the  end  of  the  third  or  fourth  day  the  poultice  or  the 
bath  may  be  discontinued,  and  the  opening  in  the  sole 
dressed  with  any  suitable  astringent  and  antiseptic. 

The  most  serious  complication  arising  from  this  method 
of  treatment  is  one  of  excessive  granulation  of  the  sensitive 
sole.  This  we  find  to  be  successfully  held  in  check  by  a 
daily  application  of  undiluted  Spts.  Hydrarg.  Perchlor. 
(Tuson).  Should  the  granulations  become  very  exuberant, 
then  the  knife  must  be  called  to  our  aid,  and  the  wound  so 
made  afterwards  dressed  with  an  astringent. 

When  the  suppuration  has  under-run  the  horny  frog 
there  should  be  no  hesitation  in  at  once  removing  all  the 
horn  that  is  visibly  separated  from  the  sensitive  structures 
beneath. 

When  the  os  pedis  is  splintered  and  carious,  a  portion  of 
the  sole  round  the  wound  is  removed,  and  the  bone  exposed. 
The  diseased  portion  is  scraped  away  either  with  curette 

:':  At  the  time  of  writing-  this,  a  certain  amount  of  discussion 
is  going  on  in  our  veterinary  journals  as  to  whether  a  hot 
or  a  cold  bath  is  the  one  indicated.  It  is  urged  the  application 
of  heat  that  it  favours  organismal  growth  and  reproduction, 
and  tends  rather  to  induce  the  spread  of  the  suppurative  pro- 
cess than  to  overcome  it.  Those  who  hold  this  opinion  urge 
in  support  of  it  that  cold  application  are  inimical  to  the  life 
of  the  pus  organism.  At  the  same  time,  it  must  be  remem- 
bered that  in  just  so  far  as  cold  inhibits  the  growth  of  the 
invading  germ,  so  in  just  the  same  degree  does  it  adversely 
influence  the  functions  of  the  tissues  that  are  to  fight  against 
it.  To  our  minds  the  question  thus  set  up  must  always  remain 
more  or  less  a  mootpoint,  and  while  we  fully  agree  that  cold 
undoubtedly  checks  the  growth  of  septic  material,  we  just  as 
fully  believe  that  warmth  serves  to  place  the  healthy  surround- 
ing structures  in  a  far  better  condition  to  maintain  a  vigorous 
phagocytosis  against  it.  YVe  thus  continue  to  advise  a  hot 
antiseptic  poultice,  or,  better  still,  a  bath. — The  Author. 


222         DISEASES  OF  THE  HORSE'S  FOOT 

or  with  the  point  of  the  drawing-knife.  In  this  case  the 
only  after-treatment  called  for  is  the  application  of  suitable 
antiseptic  dressings. 

When  necrosis  of  the  plantar  aponeurosis  has  occurred. 
We  have  already  pointed  out  the  tendency  there  is  in  this 
case  for  the  wound  to  maintain  a  fistulous  character,  and 
lead  to  the  formation  of  abscesses  in  the  hollow  of  the  heel. 
With  a  wound  in  this  position,  as  with  a  wound  in  any 
other,  the  only  method  of  avoiding  this  termination  consists 
in  removing  all  that  is  visibly  diseased,  whether  it  be  soft 
structures,  bone,  ligament,  or  tendon,  and  giving  the  wound 
free  drainage. 

This  can  only  be  done  by  removing  the  horny  sole  and 
frog,  and  cutting  boldly  down  upon  the  structures  beneath. 
The  operation  is  known  as  resection  of  the  plantar  apo- 
neurosis, or  the  complete  operation  for  gathered  nail. 

Practised  for  some  years  on  the  Continent,  this  operation, 
on  account  of  its  gravity,  has  been  avoided  by  English 
veterinarians.  From  reported  cases,  however,  it  appears 
often  to  be  followed  by  success. 

That  there  is  a  large  element  of  risk  in  the  operation 
is  quite  evident,  if  only  from  the  two  facts  mentioned  be- 
neath : 

1.  That  the  close  attachment  of  the  plantar  aponeurosis 
to  the  navicular  bursa,  and  the  nearness  of  both  to  the 
pedal  articulation,  render  penetration  of  a  synovial  sac  or 
a  joint  cavity  extremely  likely. 

2.  That  there  is  always  great  difficulty  in  maintaining 
strict  asepsis  of  the  foot,  more  especially  if  it  is  a  hind  one. 

On  the  other  hand,  it  may  be  argued  that  equal  risk  to 
the  patient  is  run  in  allowing  him  to  remain  with  a  disease 
(and  that  disease  a  progressive  one)  of  the  structures  so 
closely  antiguous  to  the  navicular  bursa  and  the  pedal 
articulation. 

If  only  for  that  reason  we  give  the  operation  brief  men- 
tion here. 

The  animal  is  prepared  in  the  usual  way  for  the  operating 
bed ;  the  foot  soaked  for  a  day  or  two  previously  in  a  strong 


WOUNDS  223 

antiseptic  solution,  the  patient  cast  and  chloroformed,  and 
the  operation  proceeded  with. 

An  Esmarch's  bandage  should  be  first  applied,  and  a 
tourniquet  afterwards  placed  higher  up  on  the  limb.  The 
foot  is  then  secured  as  described  in  an  earlier  chapter,  and 
the  whole  of  the  horny  structure  of  the  lower  surface  of 
the  foot  (the  sole,  the  frog,  and  the  bars)  pared  until  quite 
near  the  sensitive  structure,  or,  if  under-run  with  pus, 
stripped  off  entirely.  An  incision  is  then  made  in  each 
lateral  lacuna  of  the  frog,  the  two  meeting  at  the  frog's 
point.  Each  incision  thus  made  should  be  carried  deep 
enough  to  cut  through  the  substance  of  the  plantar  cushion. 
A  tape  is  then  passed  through  the  point  of  the  frog,  tied  in 
a  loop,  and  given  to  an  assistant  to  draw  backwards.  The 
plantar  cushion  itself  is  then  incised  in  a  direction  from 


Fig.  106— 'Curette,'  or  Volkmann's  Spoon. 

before  backwards,  and  pulled  on  by  the  assistant,  so  as  to 
expose  the  plantar  aponeurosis. 

Should  this  be  found  at  all  necrotic,  it  may  be  taken  that 
purulent  inflammation  of  the  navicular  bursa  and  of  the 
navicular  bone  itself  exists.  The  operator  must  then  pro- 
ceed to  resection  of  the  tendon  in  order  to  treat  the  deeper 
structures  thus  affected.  At  its  point  of  insertion  into  the 
semilunar  crest  the  tendon  is  severed  and  afterwards  re- 
flected. This  exposes  the  inferior  face  of  the  navicular 
bone.  Instead  of  the  glistening  and  clear  appearance  it 
ordinarily  presents,  its  glenoid  cartilage  is  found  to  be 
showing  hemorrhagic  or  even  purulent  spots  of  necrosis. 
The  terminal  portion  of  the  tendon  must  then  be  excised. 

To  effect  this  a  clean  transverse  incision  is  made  at  the 
extreme  upper  border  of  the  navicular  bone.  Here  we  are 
in  close  contact  with  the  pedal  articulation,  and  great  care 


224         DISEASES  OF  THE  HORSE'S  FOOT 

is  necessary  in  making  this  last  incision,  in  order  that  the 
synovial  sac  may  not  be  penetrated. 

All  structures  showing  spots  of  necrosis  should  now  be 
carefully  removed,  either  with  the  knife  or  with  the  curette. 
The  knives  most  suitable  for  the  last  stages  of  this  opera- 
tion are  those  depicted  in  Fig.  45  (c,  d,  and  c).  The 
curette,  or  Volkmann's  spoon,  we  show  in  Fig.  106. 


a 


:X 


O  _^r~ 


Fig.  107. — Resection  of  Terminal  Portion  of  the  Perforans. 

The  horny  sole  and  the  horny  frog  stripped  from  off  the 
sensitive    structures. 

a,  The  plantar  cushion;  b,  b,  the  plantar  aponeurosis,  or  termi- 
nal portion  of  perforans;  c,  the  navicular  bone;  d,  interos- 
seous ligaments  of  the  pedal  articulation;  e,  e,  semilunar 
crest  of  the  os  pedis;  f,  inferior  surface  of  os  pedis;  g,  g, 
the  sensitive  lamime  of  the  bars;  Ii,  h,  bearing  surface  of 
the  wall;   /,  /,  the  sensitive   sole;   k,  the  sensitive  frog. 

When  at  all  diseased  the  glenoidal  surface  of  the  navi- 
cular bone  should  be  curetted,  even  to  the  extent  of  the 
removal  of  the  whole  of  the  cartilage.  A  healthy,  granu- 
lating surface  is  thus  insured. 

The  above  figure   from  Gutenacker's  '  Hufkrankheiten  ' 


WOUNDS  225 

explains  shortly  the  position  of  the  operation  wound  and 
the  structures,  involved,  rendering  further  description  un- 
necessary here. 

The  operation  ended,  the  dressing  follows.  Upon  this 
depends  very  largely  the  ultimate  recovery  of  the  patient, 
for  it  is  only  by  careful  attention  and  suitable  dressings 
that  effectual  repair  of  the  injured  structures  may  be 
brought  about. 

A  light  shoe  is  first  tacked  on  to  the  foot,  and  those 
portions  of  the  horny  sole  that  have  been  allowed  to  remain 
dressed  with  Venice  turpentine,  tar,  or  other  thickly- 
adherent  antiseptic. 

The  exposed  soft  tissues  are  then  dressed  with  pledgets 
of  tow*  soaked  in  alcohol  and  carbolic  acid.  This  dressing 
must  be  allowed  to  remain  in  position,  and  is  kept  there  by 
means  of  a  bandage,  or  the  shoe  with  plates  (Fig.  55)  and 
a  bandage  over  it.  Xo  pressure  is  needed ;  consequently, 
the  pledgets  of  tow  must  not  be  too  thick. 

In  the  after-dressing  of  the  wound  careful  attention  must 
be  paid  to  the  granulating  surface.  Where  tending  to  be- 
come too  vigorous  in  growth  it  should  be  held  in  check  by 
suitable  caustic  dressings.  At  the  same  time  it  must  be 
remembered  that  the  granulating  process  of  repair  is 
always  more  rapid  upon  the  plantar  cushion  and  fleshy 
sole  than  upon  the  bone,  or  upon  tendinous  or  cartilaginous 
structures.  As  a  result  of  this  we  have  a  wound  showing 
various  aspects  of  cicatrization.  Healthy  granulation  may 
be  profuse  in  one  spot,  while  in  another  it  may  be  checked 
either  by  a  flow  of  synovia  from  the  still  open  bursa,  or 
by  fragments  of  bone  or  of  tendon  still  acting  as  foreign 
bodies  in  the  wound.  These  latter  may  be  readily  detected 
by  their  standing  out  as  dark  and  uncovered  spots  in  the 
healthy  granulation  around,  and  should  be  at  once  removed. 

*  When  using  tow  in  the  form  of  a  pad,  it  is  well  to  remem- 
ber that  many  small  balls  of  the  material  rolled  lightly  in  the 
palm  of  the  hand  and  afterwards  massed  together  are  far  bet- 
ter thas  one  large  pad  of  the  tow  taken  without  this  prepara- 
tion. The  irregularities  of  the  wound  are  better  fitted,  and 
the   whole   dressing   easier   remains  in  situ    (H.    C.   R.). 


226        DISEASES  OF  THE  HORSE'S  FOOT 

The  time  that  an  operation  wound  of  this  description 
takes  to  heal — and  that  without  complication — is  from  one 
to  two  or  three  months.  Continuation  of  pain  and  inten- 
sity of  lameness  are  not  to  be  taken  as  indications  of 
failure.  The  reparative  inflammation  in  the  synovial 
membrane  is  quite  sufficient  to  induce  pain  severe  enough 
to  prevent  the  animal  from  placing  his  foot  to  the  ground 
for  some  weeks,  even  though  the  progress  of  the  case,  all 
unknown,  may  be  all  that  is  desired.  So  long  as  a  great 
amount  of  pain  is  absent,  and  so  long  as  appetite  remains 
and  swellings  in  the  hollow  of  the  heel  fail  to  make  their 
appearance,  so  long  may  the  progress  of  the  case  be  deemed 
satisfactory. 

Recorded  Case  of  the  Treatment. — A  cart-horse,  aged  six 
years,  was  sent  to  the  Alfort  School  by  a  veterinary  surgeon 
for  having  picked  up  a  nail  in  the  hind-foot.  Professor 
Cadiot,  judging  the  necessity  for  the  complete  operation, 
performed  it  on  January  14,  and  spared  the  plantar  cushion 
ac  much  as  possible.  In  consequence  of  the  plantar  apo- 
neurosis being  extensively  necrosed,  it  was  advisable  to 
scrape  the  navicular  bone  and  a  part  of  the  semilunar 
crest.  The  wound  having  been  washed  with  a  1  per  cent, 
solution  of  perchloride  of  mercury,  it  was  dusted  with  iodo- 
form and  packed  with  gauze,  and  covered  with  a  cotton- 
wool dressing,  kept  in  position  by  means  of  a  suitable  shoe. 

On  January  16  there  was  no  snatching  up  of  the  limb 
when  the  horse  was  made  to  put  weight  upon  it;  he  ate 
his  food  well,  and  his  condition  improved  every  day.  On 
January  21  the  dressing  was  removed ;  the  wound  appeared 
pinky  and  granular,  and  there  was  no  suppuration.  The 
clot  remaining  from  the  haemorrhage  after  the  operation 
was  removed,  the  wound  was  irrigated  with  a  hot  solu- 
tion of  sublimate,  and  then  dusted  with  iodoform  and 
covered  with  a  dressing  of  iodoform  gauze  and  absorbent 
wool.  At  this  date  the  horse  could  stand  on  the  injured 
limb.  On  January  31a  second  dressing  was  made,  and  the 
animal  almost  walked  sound.  On  February  7  the  wound 
had  almost  closed  up,  save  in  its  central  part,  where  there 


WOUNDS  227 

was  a  small  cavity,  and  the  lameness  had  disappeared.  On 
February  15  the  wound  had  completely  healed,  and  its 
borders  were  covered  by  a  layer  of  thin  horn.  As  the 
animal  was  sound  it  was  sent  to  work. 

The  author  directs  attention  to  the  rapidity  with  which  a 
large  and  complete  wound  cicatrizes  after  the  operation  for 
gathered  nail.* 

In  the  case  of  Penetrated  Navicular  Bursa,  unaccom- 
panied by  the  formation  of  any  large  quantity  of  pus,  and 
uncomplicated  by  necrosis  of  the  aponeurosis,  our  aim  must 
be  to  maintain  the  wound  in  that  happy  condition.  This  is 
doubtless  best  done  by  keeping  the  foot  continually  in  a 
cold  bath,  rendered  strongly  antiseptic  by  the  addition  of 
sulphate  of  copper  and  perchloride  of  mercury.  Should 
there  be  intervals  when  the  bath  must  be  neglected,  the 
foot  in  the  meantime  must  be  kept  clean  by  antiseptic 
packing  and  bandaging,  and  a  clean  bag  over  all.  This 
treatment  should  be  continued  so  long  as  the  character  of 
the  discharge  denotes  that  synovia  is  running.  If,  in  spite 
of  our  precautions,  the  discharge  becomes  purulent,  then 
the  track  made  by  the  penetrating  object  should  be  syringed 
twice  daily  with  a  1  in  1,000  solution  of  perchloride  of 
mercury. 

During  the  treatment  it  will  be  wise  to  shoe  the  animal 
with  a  high-heeled  shoe.  We  do  not  know  as  yet  the  full 
extent  of  the  injury.  The  navicular  bone  may  be  tending 
to  caries ;  or  necrosis  of  the  plantar  aponeurosis,  all  un- 
known, gradually  becoming  pronounced.  This  calls  for  a 
relief  of  tension  on  the  perforans,  and  is  only  to  be  brought 
about  by  the  high-heeled  shoe. 

The  result  of  the  inflammatory  changes  in  the  tendon, 
aided  possibly  by  the  use  of  the  high-heeled  shoe,  is  to  after- 
wards bring  about  contraction.  Where  this  has  occurred, 
and  the  animal  walks  continuously  on  his  toe,  the  shoe  with 
the  projecting  toe-piece  (Fig.  84)  must  be  applied.  AYhen 
the  continual  use  of  the  toe-piece  appears  inadvisable,  the 

*    Veterinary  Record,  vol.    ii.,   p.   371.         


228        DISEASES  OF  THE  HORSE'S  FOOT 

shoe  devised  by  Colonel  Nunn  may  be  used  in  its  stead  (see 
Fig.  108). 

The  toe-piece  is  screwed  into  the  toe  of  the  shoe  when 
the  horse  is  about  to  be  exercised,  and  forms  a  powerful 
point  of  leverage  with  which  to  stretch  the  contracted 
tendon,  and  the  shoe,  .being  thin  at  the  heels,  admits  of 
this.  The  advantage  of  this  form  of  toe-piece  over  the 
ordinary  form  of  fixed  toe-lever  is  that  it  can  be  removed 
when  the  horse  is  in  the  stable ;  while  the  curved  point 
diminishes  the  danger  of  the  horse  hurting  itself — a  danger 
always  present  if  it  is  on  a  hind-foot.  (  See  also  Treat- 
ment of  Purulent  Arthritis  in  Chapter  XII.) 

Should  a  Sinuous  Wound  remain  in  the  region  of  the 
Lateral  Cartilage,  it  should  be  explored,  and  its  depth  and 


Fig.  108. — Colonel  Nunn's  Shoe  with  Detachable  Toe 
Extension. 

likely  number  of  branches  ascertained.  Should  this  ex- 
ploration denote  that  the  cartilage  itself  is  diseased,  or  that 
the  wound  is  not  able  to  be  sufficiently  drained  from  the 
sole,  then  we  know  that  we  have  on  our  hands  a  case  of 
c»uittor.  The  treatment  necessary  in  such  a  case  will  be 
found  described  in  Chapter  X. 

When  the  Complication  of  Purulent  Arthritis  has  arisen, 
the  surgeon  has  to  admit  to  himself,  reluctantly  no  doubt, 
that  the  case  is  often  beyond  hope  of  aid  from  him. 
Nothing  can  be  done  save  to  order  continuous  antiseptic 
baths  and  antiseptic  irrigation  of  the  wounds  with  a  quittor 
syringe,  and  to  attend  to  the  general  health  and  condition 
cf  the  patient.  At  the  best  it  is  but  a  sorry  look-out  both 
for  the  veterinary  attendant  and  the  owner  of  the  animal. 
Even  with  resolution  incurable  lameness  results,  and  the 


WOUNDS  229 

animal  is  afterwards  more  or  less  a  walking  exhibition  of 
the  limitations  of  surgery,  while  the  owner,  unless  the  ani- 
mal is  valuable  for  the  purpose  of  breeding,  finds  himself 
encumbered  with  a  life  that  is  practically  useless.  (See 
Treatment  of  Purulent  Arthritis,  Chapter  XII.) 

In  the  case  of  Lameness  Persisting  after  the  healing  of 
all  appreciable  lesions,  then  neurectomy  is  followed  by  good 
results.  The  animal,  apparently  recovered,  is  for  a  long 
time  useless.  Lameness  persists  for  several  months,  as  if 
the  nail  had  at  the  moment  of  its  penetration  caused  lesions, 
which  doubtless  it  sometimes  does,  similar  to  those  of 
navicular  disease.  Examination  of  the  foot  in  this  case 
reveals  no  lesion,  and  the  pain  has  evidently  a  deep  origin. 
The  lameness  caused  by  it  is  subject  to  variation.  Fre- 
quently it  becomes  lessened  during  rest,  and  increased  by 
hard  work,  while  sometimes  it  is  very  much  more  pro- 
nounced at  starting  than  after  exercise. 

It  is  here  that  neurectomy  is  called  for.  The  operation 
does  nothing  to  impede  the  work  of  healing  going  on,  and 
allows  free  movement  of  the  foot  and  pastern  to  take  place. 
A1  the  same  time  suffering  and  emaciation  cease,  and  the 
animal  is  rendered  workable.* 

C.    COEOXITIS   (SIMPLE). 

Tread,  Overreach,  etc. 

1.  Acute. 

Definition. — Under  the  heading  of  simple  corinitis  in  its 
acute  form  we  intend  to  describe  those  inflammatory  condi- 
tions of  the  skin  and  underlying  structures  of  the  coronet 
occurring  without  specific  cause.  Specific  coronitis  will  be 
found  described  in  Chapter  IX. 

Causes. — This  condition  is  almost  invariably  set  up  by  an 
injury  either  a  bruise  or  an  actual  wound — to  the  coronet. 
By  far  the  most  common  among  such  injuries  are  those 
inflicted  by  the  animal  himself  by  means  of  the  shoes. 

That   known   as   '  tread  '   is   caused  by  the   shoe  on   the 

*  Veterinary  Record,  vol.  ii.,  p.  371. 


230        DISEASES  OF  THE  HORSE'S  FOOT 

opposite  foot,  and  may  happen  in  a  variety  of  ways.  More 
often  than  not  it  is  met  with  in  the  feet  of  heavy  draught 
animals,  and  is  there  caused  by  the  calkin,  either  when 
being  violently  backed  or  suddenly  turned  round.  It  may 
also  occur  in  horses  with  itchy  legs,  as  a  result  of  the 
animal  rubbing  the  leg  with  the  shoe  of  the  opposite  limb. 
The  irritation  in  this  case  is  nearly  always  due  to  parasitic 
infection  (Symbiotes  equi),  and  becomes  sometimes  so  un- 
bearable as  to  render  the  animal  unmindful  of  the  injury 
he  may  be  inflicting  so  long  as  he  experiences  the  relief 
obtained  by  the  rubbing. 

Self-inflicted  tread  is  also  sometimes  met  with  when 
horses  are  worked  abreast  at  plough.  The  animal  in  the 
furrow,  with  one  foot  sometimes  in  and  sometimes  out  of 
the  hollow,  is  caused  to  make  a  false  step,  and  so  brings 
the  injury  about. 

Animals  worked  in  pairs  are  further  liable  to  receive  a 
tread  from  the  foot  of  their  companion.  This  is  commonly 
seen  in  heavy  animals  at  agricultural  labour  in  fields, 
where  the  walking  is  uneven,  and  abrupt  turning  constant. 
It  is  not  uncommon  either  in  animals  at  work  in  vans  in 
town,  and  is  occasionally  met  with  in  the  feet  of  carriage- 
horses. 

'  Overreach  '  is  the  term  used  to  indicate  the  injury  in- 
flicted on  the  coronary  portion  of  the  heel  of  the  fore-foot 
by  the  shoe  of  the  hind.  Ordinarily,  overreach  occurs 
when  the  animal  is  at  a  gallop,  and  is  thus  met  with  in  its 
severest  form  in  hunters  and  steeplechasers.  It  can  only 
occur  when  the  fore-foot  is  raised  from  the  ground  and  the 
hind-foot  of  the  same  side  reached  right  forward.  When 
the  feet  separate  the  injury  takes  place.  In  its  movement 
backwards  the  inner  border  of  the  shoe  of  the  hind- 
foot  catches  the  coronet  of  the  fore,  and  tears  it  backwards 
with  it.  Quite  frequently  a  portion  of  the  skin  is  removed 
entirely,  but  often  it  hangs  as  a  triangular  flap.  The  flap 
in  such  a  case  is  always  attached  by  its  hindermost  edge, 
and  indicates  plainly  enough  that  the  direction  of  the  blow 
that  cut  it  must  have  been  from  before  backwards. 


WOUNDS  231 

Although  ordinarily  inflicted  at  the  gallop,  the  same 
injury  may,  nevertheless,  be  caused  by  allowing  a  fast 
trotter,  and  one  with  extreme  freedom  of  action  behind,  to 
push  forward  at  the  utmost  limit  of  his  pace.  The  outside 
heel  is  the  one  most  subject  to  the  injury. 

While  the  common  form  of  injury  to  the  coronet  is,  as 
we  have  described,  that  occasioned  by  the  animal's  own 
shoe,  or  that  of  a  companion,  it  is  evident  that  the  foot  is 
also  open  to  similar  injuries  from  quite  outside  sources. 
Palls  of  the  shafts  when  unyoking  animals  from  a  heavy 
cart,  blows  or  wounds  from  the  stable  fork,  wounds  result- 
ing from  the  foot  becoming  fixed  in  a  gate  or  a  fence,  either 
may  equally  well  set  up  the  mischief. 

Apart  from  severe  injury,  a  particularly  troublesome 
form  of  coronitis  may  arise  from  the  condition  of  the 
roads.  We  refer  to  the  conditions  attendant  on  a  thaw 
after  snow.  The  animal  is  called  upon  to  labour  in,  or  per- 
haps stand  for  long  periods  in,  a  mixture  of  snow  and 
water,  or  snow  and  mud.  That  this  must  have  a  preju- 
dicial effect  upon  the  structure  of  the  coronet  is  plain.  The 
circulation  of  the  part,  already  predisposed  to  sluggishness 
by  reason  of  its  distance  from  the  heart,  is  further  impeded 
by  the  action  of  the  cold.  Small  abrasions  of  the  skin,  so 
small  as  to  scarce  be  noticeable,  are  in  this  case  freely  open 
to  infection  with  the  septic  matter  the  mud  contains. 
Necrosis  and  consequent  sloughing  of  the  skin  is  bound  to 
follow,  and  an  extensive  ulcerous  wound,  or  a  spreading 
suppuration  of  the  coronary  cushion  is  the  result. 

Syjtiptotns. — We  will  take  first  the  case  in  which  no 
actual  wound  is  observable.  Here  the  first  indication  of 
the  trouble  is  the  appearance  of  an  inflammatory  swelling, 
confined  usually  to  one  side,  but  extending  sometimes  to 
the  whole  of  the  coronet.  Always  the  part  is  hot  and 
tender,  and  with  it  the  patient  is  lame — so  much  so,  in 
many  cases,  as  to  be  unable  to  put  the  foot  to  the  ground, 
the  toe  alone  being  used. 

In  a  mild  case,  uncomplicated  by  septic  infection,  these 
symptoms  rapidly  subside,  and  resolution  occurs. 


232         DISEASES  OF  THE  HORSE'S  FOOT 

Always,  however,  the  presence  of  septic  infection  must 
be  suspected  and  looked  for.  When  this  has  occurred,  the 
inflammatory  swelling  becomes  larger  and  more  diffuse, 
and  the  animal  fevered  This  is  then  followed  by  a  slough 
of  the  injured  part.  A  portion  of  the  skin  first  becomes 
gray,  or  even  black,  in  appearance,  and  around  it  oozes  an 
inflammatory  exudate,  or  even  pus.  The  skin  immediately 
adjoining  the  spot  of  necrosis  is  swollen  and  hyperaemic, 
and  extremely  painful  and  sensitive.  Later,  the  necrosed 
portion  becomes  cast  off,  and  an  open  wound  remains. 
This  as  a  rule  marks  the  turning-point  in  the  case.  The 
pain  and  other  symptoms  rapidly  abate,  and  the  wound, 
with  proper  attention,  is  not  more  than  ordinarily  difficult 
to  treat. 

In  the  case  of  an  actual  wound  the  symptoms  are  prob- 
ably less  severe.  The  injury  is,  in  this  instance,  the  sooner 
detected,  and  remedial  measures  put  into  operation.  In 
this  manner  the  formation  of  septic  material  is  often 
checked,  and  nothing  but  the  treatment  of  a  simple  wound 
demands  attention. 

There  are,  however,  complications. 

Complications — (a)  Diffuse  Purulent  Inflammation  of  the 
Sub-coronary  Tissue. — This  condition  is  brought  about  by 
the  spread  into  the  loose  tissue  of  the  coronary  cushion  of 
the  septic  material  introduced  by  the  tread.  The  whole 
coronet  in  this  instance  becomes  excessively  swollen,  hot, 
and  painful,  and  the  dangerous  nature  of  the  complication 
is  evident  enough  when  the  structure  and  situation  of  the 
parts  involved  is  considered.  The  amount  of  tendinous 
and  ligamentous  material  in  the  neighbourhood  offers  a 
strong  predisposition  to  necrosis,  and  the  necrosis,  with  its 
attendant  formation  of  pus,  offers  a  further  danger  when 
the  close  proximity  of  the  pedal  articulation  and  the  un- 
yielding character  of  the  horny  box  is  considered  with  it. 

The  pus  formed  in  this  condition  may  remain  confined  to 
the  coronet  and  break  through  the  skin  as  an  ordinary  ab- 
scess, or  it  may,  before  so  doing,  burrow  beneath  the  wall 
and  invade  the  sensitive  laminae.     In  this  case,  whenever 


WOUNDS 


233 


portions  of  the  secreting  layer  of  the  keratogenous  mem- 
brane are  destroyed,  or  perhaps  only  temporarily  prevented 
from  fulfilling  their  horn-producing  functions,  then  corre- 
sponding cavities  in  the  horn  are  the  result  (see  Fig.  109). 

(b)  Pit  nil  cut  Arthritis. — Only  too  readily  the  pus  so 
formed  tends  to  penetration  of  the  articulation  and  the 
causation  of  an  incurable  arthritis   (see  Chapter  XII.). 

(  c)  Necrosis  of  the  Extensor  Pedis. — This  may  arise 
either  as   a   result  of   spreading  purulent  infection   of   the 


Fig.  109. — Mesial  Section  of  a  Hoof  illustrating  the  Conditions 
following  upon   Coronitis. 

a,  Cavity  in  the  horn  of  the  wall;  b,  enlargement  of  the  coronet 
and  the  horn  of  the  wall  following  subcoronary  suppura- 
tion: c,  cavity  in  the  wall  following  purulent  inflammation 
of  the  sensitive  laminae;  d,  hollow  in  the#  horn  of  the  sole 
consequent  upon  suppuration  of  the   sensitive  sole. 


coronary  cushion,  or  as  a  result  of  direct  injury  immedi- 
ately over  it.  The  close  relation  of  the  terminal  portion  of 
this  tendon  with  the  pedal  articulation,  and  the  incomplete 
protection  from  outside  injuries  here  afforded  to  the  joint 
by  the  horny  box,  sufficiently  points  out  the  gravity  of  the 
condition. 

(d)  Penetration  of  the  Articulation. — This  also  may  be  a 
result  either  of  the  inroads  made  by  pus,  or  of  an  actual 
wound.  When  occurring  from  the  latter,  it  is  seen  more 
often  than  not  in  the  hind-foot,  being  there  caused  by  the 


234        DISEASES  OF  THE  HORSE'S  FOOT 

calkin  of  the  opposite  foot,  Where  a  wound  in  this  posi- 
tion is  characterized  by  an  excessive  flow  of  synovia,  the 
condition  should  be  suspected,  and,  if  the  wound  be  large 
enough,  the  little  finger  should  be  introduced  in  order  to 
ascertain.     Needless  to  say,  the  injury  is  a  grave  one. 

(e)  Sand-crack. — Sand-crack  is  likely  to  result  from 
tread  when  an  injury  is  inflicted  in  the  region  of  the  quarter 
by  a  severe  overreach.  Treads,  too,  especially  with  the 
calkin  of  the  hind-shoe,  are  especially  apt  to  end  in  this  way. 
In  this  latter  instance  the  sand-crack  usually  has  its  origin 
in  a  nasty  jagged  tear  at  the  top  of  the  wall  of  the  toe. 

(/)  Quittor. — In  one  respect  any  suppurating  wound  at 
the  coronet  may  be  deemed  a  quittor.  By  indicating  quittor 
as  a  complication  of  coronitis,  however,  we  denote  the 
more  serious  form  of  this  disease,  in  which  the  wound  has 
taken  on  a  sinuous  character,  and  conducted  pus  to  invasion 
cf  the  lateral  cartilage.  It  is  one  of  the  worst  complica- 
tions we  are  likely  to  meet  with  in  this  condition,  and  will 
be  found  fully  described  in  Chapter  X. 

(g)  False  Quarter. — This  complication  of  coronitis  occurs 
when  the  injury  or  after-effect  of  the  formation  of  pus  has 
been  severe  enough  to  destroy  outright  a  comparatively 
large  portion  of  the  papillary  layer  of  the  coronary  cushion. 
To  this  condition  we  devote  Section  D  of  this  chapter. 

Prognosis. — In  giving  a  prognosis  in  a  case  of  coronitis, 
attention  should  be  paid  to  the  manner  in  which  the  condi- 
tion originated,  and  the  etxent,  when  present,  of  the  wound. 

When  the  inflammatory  swelling  has  arisen  from  bruis- 
ing alone,  without  actual  division  of  the  skin,  when  the 
weather  is  that  of  winter,  and  the  swelling  showing  a 
marked  tendency  to  spread,  then  the  prognosis  must  be 
guarded.  As  we  have  seen,  this  state  of  affairs  is  probably 
ushering  in  a  condition  of  spreading  suppuration  of  the 
coronary  cushion,  and  considerable  gangrene  and  slough- 
ing of  the  skin.  We  have  here  no  intimation  as  yet  of 
how  far  the  suppurative  process  may  run,  nor  what  im- 
portant structures  it  may  involve.  Consequently,  the 
guarded  prognosis  we  have  mentioned  is  imperative. 


WOUNDS  235 

When  an  actual  wound  is  to  be  seen,  and  where  advice 
is  sought  early,  then  a  more  favourable  opinion  may  be 
advanced.  In  this  case  antiseptic  measures,  commenced 
early  and  persisted  in,  may  prevent  the  rise  of  further 
mischief. 

It  goes  without  saying  that,  should  there  arise  any  other 
of  the  complications  we  have  mentioned  (viz.,  Arthritis, 
Necrosis  of  the  Extensor  Pedis,  Sand-crack,  Quittor,  and 
False  Quarter),  the  fact  should  be  pointed  out  to  the  owner, 
and  the  prognosis  regulated  thereby. 

Treatment  Preventive. — Seeing  that  at  any  rate  the 
majority  of  cases  of  coronitis  result  from  injuries  inflicted 
by  the  shoes,  we  may  look  at  once  to  that  particular  for  a 
means  of  prevention. 

Take  first  the  case  of  '  treads.'  There  is  no  doubt  that 
they  are  most  common  in  animals  shod  with  heavy  shoes 
and  with  high  and  sharp  calkins.  This  suggests  at  once 
that  a  preventive  is  to  be  found  in  substituting  a  calkin 
that  is  low  and  square. 

Where  the  injury  is  an  overreach,  and  where,  on  account 
of  the  animal's  pace  and  manner  of  gait  it  is  in  risk  of  being 
constantly  inflicted,  the  shoeing  should  be  seen  to  at  once. 
We  have  already  pointed  out  that  it  is  the  inner  border 
of  the  lower  surface  of  the  toe  of  the  hind-shoe  which,  in 
the  act  of  being  drawn  backwards,  inflicts  the  injury.  (See 
Fig.  110). 

In  this  case  prevention  may  be  brought  about  either  by 
shoeing  with  a  shoe  whose  ground  surface  is  wholly  con- 
cave, or  by  bevelling  off  the  sharp  border  (see  Fig.  110,  a, 
p.  236).  When  the  tendency  to  overreach  is  not  exces- 
sive, prevention  may  in  many  cases  be  effected  by  simply 
placing  the  shoe  of  the  hind-foot  a  trifle  further  backwards 
than  would  ordinarily  be  correct,  thus  allowing  the  horn  of 
the  toe  to  project  beyond  the  shoe.  This  at  the  same  time 
does  away  with  the  annoyance  of  *  forging  '  or  '  clacking,' 
which,  as  a  rule,  accompanies  this  condition. 

While  recognising  the  value  of  shoeing  in  these  cases,  we 
must  not  forget  that  a  great  deal  may  be  brought  about  by 


236        DISEASES  OF  THE  HORSE'S  FOOT 


careful  horsemanship.  The  animal  should  be  held  together 
and  kept  well  up  to  the  bit,  but  should  not  be  allowed  to 
push  forward  at  the  top  of  his  pace.  With  many  animals 
of  fast  pace  and  free  action  overreach  is  more  an  indis- 


Fig.  110. — Under  Surface  of  the  Toe  of  a  Hind-shoe. 

a,  Marks  the  portion  of  the  inner  margin  that  inflicts  overreach. 

cretion  of  youth  than  any  defect  in  action  or  conformation, 
and  his  powers  should  therefore  be  husbanded  by  the  driver 
until  the  animal  has  settled  down  into  a  convenient  and 
steady  manner  of  going. 

Curative. — Although  in  some  cases  it  is  so  small  as  to  go 
undetected,  we  may  take  it  that  in  all  cases  of  coronitis 


Fig.  111. — The  Inner  Margin  of  the  Inferior  Surface  of  the 
Hind-shoe  Bevelled  to  prevent  Overreach. 

there  is  a  wound,  with  consequent  danger  of  septic  infection 
of  the  surrounding  parts.  Therefore,  after  attention  to  the 
shoeing  and  removal  of  the  cause,  the  first  indication  in  the 
treatment  will  be  to  render  the  parts  aseptic.     This  is  best 


WOUNDS  237 

done  by  removing  the  hair  from  the  coronet  and  soaking 
the  whole  foot  in  a  cold  antiseptic  solution.  After  removal 
from  the  bath,  the  coronet  may  be  dressed  with  a  moder- 
ately strong  solution  of  carbolic  acid  or  perchloride  of 
mercury.  When  the  injury  is  slight  and  recent,  such  is 
sufficient  to  effect  resolution. 

When  marked  swelling  persists,  however,  and  the  in- 
crease in  heat  and  tenderness  denotes  the  formation  of  pus, 
recovery  is  not  so  easily  obtained.  In  this  case  the  appli- 
cation of  hot  poultices  or  hot  baths  is  called  for.  By  these 
means  suppuration  is  promoted  and  induced  to  early  break 
through  in  the  most  favourable  position — namely,  the 
softened  skin  of  the  coronet.  The  pus  so  escaping  is  always 
more  or  less  blood-stained,  and  contains  both  large  and 
small  pieces  of  broken  down  and  decomposed  tissue.  After 
discharge  of  the  pus,  the  cavity  remaining  should  be 
mopped  out  with  an  antiseptic  solution,  and  a  pledget  of 
antiseptic  tow  or  other  material  left  in  position.  All  that 
is  then  needed  is  constant  dressing  in  a  suitable  manner. 
We  prefer  in  this  instance  washing  some  three  or  four  times 
a  day  with  hot  water  until  a  perfectly  clean  wound  is  ob- 
tained, and,  after  the  washing,  painting  the  raw  surface 
with  a  strong  solution  (1  in  200,  or  1  in  100)  of  perchloride 
of  mercury. 

When  the  abscess  we  have  described  as  forming  is  ex- 
tremely large,  or  where  it  is  more  than  ordinarily  slow  in 
1  pointing;  the  likelihood  of  its  having  burrowed  for  some 
distance  below  the  upper  margin  of  the  wall  must  be  sus- 
pected. Here  it  is  sometimes  wise  to  thin  the  wall  with 
the  rasp  immediately  below  the  point  of  greatest  swelling 
of  the  coronet.  This  will  serve  to  lessen  pressure  on  the 
sensitive  structures  beneath. 

Immediately  the  abscess  contents  have  found  exit  at  the 
coronet,  the  cavity  formerly  occupied  by  the  pus  should 
be  explored.  If  to  any  extent  it  is  found  then  to  have 
'  pocketed  '  beneath  the  upper  border  of  the  wall,  a  counter- 
opening  should  be  made  where  the  horn  of  the  wall  has 
been  thinned  with  the  rasp. 


238        DISEASES  OF  THE  HORSE'S  FOOT 

When  it  so  happens,  either  from  extensive  bruising  or 
from  the  action  of  excessive  cold,  that  we  have  or  suspect 
the  condition  of  sloughing,  then  the  first  indication  is  to 
aid  the  live  tissues  to  throw  off  the  necrosed  portion.  In 
spite  of  what  is  sometimes  urged  to  the  contrary,  a  hot 
poultice  is,  perhaps,  the  best  means  of  bringing  this  about. 
Directly  the  necrosed  piece  is  shed,  a  wound  remains  which, 
so  far  as  treatment  is  concerned,  may  be  regarded  exactly 
as  that  left  by  the  formation  of  pus.  Hot  water  applica- 
tions, some  three  or  four  times  daily,  will  serve  both  to 
cleanse  the  wound  and  also  to  maintain  vitality  in  the 
tissues  immediately  surrounding  it.  After  each  washing, 
the  use  of  a  strong  antiseptic  solution  to  the  wound  is  again 
beneficial. 

In  the  case  of  an  actual  wound,  whether,  as  in  over- 
reach, affecting  the  coronet  alone  or  involving  destruction 
of  part  of  the  wall,  or,  as  in  the  case  of  toe-tread,  pene- 
trating the  pedal  articulation,  the  treatment  to  be  followed 
is  simple  enough,  in  theory,  if  not  always  easy  to  carry  out. 
It  consists  solely  in  maintaining  a  rigid  asepsis  of  the  parts 
until  healing  is  well  advanced  or  complete.  The  whole  foot, 
including  the  coronet,  should  first  be  thoroughly  washed  in 
warm  water.  At  the  same  time  there  should  be  used  some 
agent  that  will  tend  to  remove  the  natural  grease  of  the 
parts.  In  this  manner  cleansing  will  be  rendered  more 
thorough,  and  penetration  of  the  antiseptic  solution  to  be 
afterwards  applied  made  the  more  certain.  The  most  ready 
way  of  effecting  this  is  to  use  the  ordinary  stable  '  water  '- 
brush,  and  plenty  of  a  freely-lathering  soap. 

This  done,  the  foot  should  be  rinsed  in  cold  water,  and 
afterwards  constantly  soaked  in  a  cold  antiseptic  bath. 
Where  it  is  inconvenient  or  impossible  to  have  the  constant 
bathing  carried  out,  a  dry  antiseptic  dressing  may  be  tried 
in  its  stead.  In  this  case  the  foot  should  first  be  thoroughly 
washed  and  dressed  as  before.  Afterwards  an  antiseptic 
powder  in  the  shape  of  a  mixture  of  iodoform  1  part, 
boracic  acid  10  parts,  should  be  freely  dusted  on  the  wound, 
a  pledget  of  carbolized  tow  or  cotton-wool  placed  over  it, 


WOUNDS  239 

and  the  whole  maintained  in  position  with  a  bandage 
previously  soaked  in  a  1  in  500  solution  of  perchloride  of 
mercury.  Once  on,  this  dressing  should  be  allowed  to 
remain  until  healing  is  complete.  Should  the  animal 
manifest  pain,  however,  by  constantly  pawing,  or  should 
swelling  and  heat  of  the  parts  be  suspected,  the  bandage 
should  be  removed,  and  the  condition  of  the  wound  ascer- 
tained. 

An  excellent  example  of  the  value  of  this  method  of 
treatment  is  that  given  below  : 

'  I  call  to  mind  a  valuable  hunter  in  my  practice  a  few 
seasons  since,  who.  whilst  hunting,  we  suppose,  struck  him- 
self in  the  way  we  suggest.  He  not  only  removed  the 
superior  portion  of  the  inner  heel,  but  tore  about  3  inches 
of  the  hoof  from  the  top  nearly  to  the  bottom.  This  was 
clapped  back  by  the  owner,  tied  with  a  handkerchief,  and 
the  horse  removed  home.  When  the  handkerchief  was 
lemoved,  I  confess  I  did  not  think  the  horse  looked  at  all 
like  hunting  again.  The  heel  was  fairly  pulled  down,  the 
portion  of  the  hoof  that  was  hanging  to  it  I  could  easily 
have  wrenched  off.  The  parts  were  fomented,  however, 
with  warm  water  which  was  slightly  carbolized.  I  then 
removed  a  great  portion  of  the  heel  and  the  lateral  cartilage, 
which  was  split;  placed  the  portion  of  hoof  again  on  the 
laminae,  smothered  the  wound  with  iodoform  pulv.,  covered 
it  with  cotton-wool  packing,  and  all  the  boracic  acid  I  could 
get  it  to  hold.  A  piece  of  linen  bandage  was  then  tightly 
wrapped  a  few  times  round,  and  the  lot  enclosed  in  a 
plaster-of-Paris  bandage.  It  did  not  undo  it  for  a  fortnight, 
when,  to  my  great  pleasure,  the  heel  and  hoof  presented  a 
highly  satisfactory  appearance.  I  did  it  up  in  much  the 
same  way  for  another  ten  days,  then  put  the  sand-crack 
clamps  into  the  hoof  and  fixed  it  to  the  sound  part.  The 
hoof  remained  in  position  while  the  new  horn  grew  from 
the  top,  and  the  horse  hunted  again  the  same  season.'* 

Sequels. — Either  of  the  complications  we  have  mentioned 

*  Veterinary  Record,  vol.  ix.,  p.  501   (Bower). 


240        DISEASES  OF  THE  HORSE'S  FOOT 

— as,  for  instance,  Arthritis,  Sand-crack,  or  Quittor — may 
persist  and  remain  as  sequels  to  the  case.  In  addition  to 
these,  there  may  be  left  behind  a  cavity  in  the  horn  of  the 
wall  (see  Fig.  109),  or  a  loss  of  the  horn-substance  of  the 
wall  proper,  as  that  depicted  in  Fig.  112,  or  described  under 
the  heading  of  False  Quarter. 


Fig.  112.— Hoof  with  a  Cavity  in  the  Substance  of  the  Wall 
following  upon  'Tread'  to  the  Coronet. 

The  treatment  of  Arthritis,  Sand-crack,  Quittor,  False 
Quarter,  and  Seedy-toe,  will  be  found  in  the  chapters  de- 
voted to  their  consideration. 


2.  Chronic. 

Definition. — Coronitis  in  which,  owing  to  the  persistence 
of  the  cause,  inflammatory  phenomena  continue,  resulting 
in  the  growth  of  large  fibrous  tumours  about  the  coronet. 

Causes. — In  many  cases  it  is  possible,  of  course,  that 
abnormal  large  growths  in  this  position  may  have  an  origin 
similar  to  that  of  neoplasms  elsewhere — that  is  to  say,  an 
origin  as  yet  undiscovered.  There  is  no  doubt,  however, 
that  the  majority  of    the    huge    enlargements    about    the 


WOUNDS  241 

coronet  have  their  starting-point  in  one  or  other  of  the 
diseases  to  which  the  foot  is  liable,  in  which  the  cause 
remains,  and  a  low  type  of  inflammation  persists. 

In  chronic  and  neglected  suppurating  corn,  in  untreated 
quittor,  and  in  long-standing  complicated  sand-crack,  for 
instance,  we  have  conditions  in  which  pus  and  other  septic 
matters  find  ready  entrance  into  the  subcoronary  tissues. 
Should  either  of  these  be  negletced,  or  should  the  pus 
formation  from  the  onset  take  on  a  slow  but  gradually 
spreading  form  (in  other  words,  should  either  of  these 
cases  run  a  chronic  rather  than  an  acute  course)  then,  with 
the  persistance  of  the  inflammatory  phenomena  so  caused, 
is  bound  to  result  a  steady  and  increasing  growth  of  in- 
flammatory fibrous  connective  tissue.  This,  as  it  grows, 
becomes  in  its  turn  penetrated  by.  the  ever-invading  pus, 
and,  under  the  stimulus  thus  caused,  itself  throws  out  new 
tissue.  And  so,  constantly  excited,  the  tumor-like  mass 
tends  to  steady  increase  in  size,  until  enlargements  are 
formed  which  one  may  sometimes  truly  term  enormous. 

Symptoms. — The  appearance  of  the  growth  is,  of  course, 
immediately  evident.  Usually  these  swellings  are  slow  in 
forming,  so  that  the  size  of  the  enlargement  depends 
entirely  upon  its  age.  We  may  thus  meet  with  growths 
of  this  description,  varying  in  weight  from  4  or  5  pounds 
to  the  almost  incredible  size  of  33^  pounds.  In  the  majority 
cf  cases  a  discharging  sore  is  to  be  found  upon  it — in  some 
cases  several.  Explored,  these  sores  reveal  their  true 
nature.  Their  lip-like  openings,  and  the  ready  manner  in 
which  they  may  be  searched  by  the  probe,  show  them  to  be 
sinuses. 

In  a  few  cases,  however,  the  outer  surface  of  these 
tumours  is  intact.  When  this  is  the  case,  it  is  possible  that 
the  growth  is  a  true  fibroma — that  is  to  say,  a  non-inflam- 
matory new  growth  of  fibrous  connective  tissue.  On  the 
other  hand,  it  may  have  resulted  from  one  or  other  of  the 
causes  we  have  enumerated,  and  its  exact  diagnosis  have 
been  impossible  until  operative  measures  had  been  proceeded 
with.     In  this  case,  small  and  encysted  foci  of  inspissated 


242        DISEASES  OF  THE  HORSE'S  FOOT 

pus  scattered  more  or  less  throughout  the  growth  indicate 
its  true  nature. 

Pain  as  a  rule  is  absent,  and,  unless  the  growth,  on 
account  of  its  size,  interferes  with  progress,  the  animal 
walks  perfectly  sound.  Here  the  patient  may,  without 
offending  the  dictates  of  humanity,  be  put  to  slow  work. 

Treatment. — In  very  many  cases,  possibly  on  account  of 
the  decreased  circulation  and  vitality  of  the  parts,  these 
growths  occur  in  aged  animals.  Here  treatment  is  not 
economic,  and  may  for  that  reason  be  put  out  of  the  ques- 
tion. Further,  the  growths  are  more  common  in  heavy 
cart  animals  of  a  lymphatic  type  than  in  those  of  a  lighter 
breed.  Couple  this  with  the  fact  that  the  tumour  is  often 
unattended  with  pain,  and  we  see  that  the  animal  is  still 
able  to  perform  his  accustomed  labour.  Here,  again, 
treatment  is  contraindicated. 

For  still  another  reason  surgical  treatment,  which  is  the 
only  treatment  likely  to  be  of  benefit,  must  not  be  under- 
taken rashly.  A  large  and  open  wound  is  bound  to  be  left 
behind.  So  large  is  it  in  many  cases  that  the  complete  cov- 
ering of  the  exposed  surface  with  epidermal  growths  from 
the  circumference  cannot  possibly  be  looked  for.  There  is 
then  left  a  large  and  horny-looking  scar,  which  is  an  even 
worse  eyesore  than  was  the  original  enlargement. 

When  the  patient  is  a  young  and  otherwise  valuable 
animal,  however,  and  when  the  case,  judged  either  by  the 
size  of  the  swelling  or  its  outside  appearance,  promises  a 
fair  measure  of  success,  operative  measures  may  be  de- 
termined on. 

In  this  case  the  author's  practice  has  been,  after  casting 
the  animal,  to  apply  a  tourniquet  to  the  limb  and  proceed 
to  excision.  A  lozenge-shaped  incision,  extending  to  near 
but  not  quite  the  circumference  of  the  swelling,  should  be 
made  with  a  large  knife  right  through  the  skin  and  deeply 
into  the  growth.  The  whole  is  then  removed,  proceeding 
in  an  excavating  manner  under  the  thickened  skin  at  the 
margin.  Haemorrhage,  though  proceeding  from  several 
apparently   large   vessels   in   the   structure   of   the   tumor, 


WOUNDS  243 

and  oozing  generally  over  the  whole  of  the  outer  surface, 
is  rarely  profuse  enough  to  interfere  with  the  operation, 
and  is  easily  controlled  by  cold  water  douches  and  the 
application  of  the  artery  forceps  to  one  or  more  of  the 
larger  vessels.  The  operation  completed,  the  larger  bleed- 
ing-points should  be  secured  by  exerting  torsion  with  the 
artery  forceps,  and  the  surface  oozing  stayed  by  frequent 
dashing  with  cold  water. 

When  the  haemorrhage  has  sufficiently  ceased,  an 
ordinary  flat  firing-iron  should  be  passed  over  the  whole 
of  the  cut  surface,  and  an  effectual  eschar  formed. 

Following  this,  and  before  removing  the  tourniquet,  the 
wound  should  be  filled  with  pledgets  of  carbolized  tow,  and 
the  whole  tightly  secured  by  a  stout  and  broad  linen 
bandage  of  not  less  than  6  yards  in  length. 

Reported  Case. — '  The  patient,  a  middle-aged  cart  mare, 
had  a  pair  of  fore-feet  the  like  of  which  I  never  saw.  As 
the  result  of  long-standing  and  imperfectly-treated  quittor 
all  over  the  seat  of  side-bone  on  the  outer  side  of  each  fore- 
foot, beginning  pretty  far  forward,  and  extending  to  the 
heel  on  the  inner  side,  filling  up  the  hollow  and  reaching 
nearly  to  the  fetlock,  was  a  big,  bulging,  hard,  calloused 
enlargement  or  tumor  standing  out  3  or  4  inches  all 
round,  covered  with  thick  horny  skin  and  stubby  hair,  and 
having  on  its  surface  the  small  openings  of  several  sinuses 
leading  deeply  down  to  the  ossified  and  diseased  cartilage 
underneath.  And  yet  with  all  this  diseased  undergrowth 
the  mare,  strangely  enough,  walked  and  trotted  sound.  I 
was  told  that  this  mare  had  been  troubled  with  suppurating 
corns  and  quittor,  that  many  unsuccessful  attempts  had 
been  made  at  cure,  but  that,  getting  worse  instead  of  better, 
these  tumors  had  formed. 

*  After  casting  and  anaesthetizing,  a  strong  rubber  tourni- 
quet was  placed  above  the  knee  and  the  operation  com- 
menced. With  a  surgeon's  amputating  knife  all  the  big 
fibrous  mass  which  I  could  safely  remove  was  cut  and 
sliced  off,  and  the  coronet  and  pastern  reduced  as  nearly  as 
possible  to  its  natural  dimensions.     The  diseased  cartilage, 


244 


DISEASES  OF  THE  HORSE'S  FOOT 


or  side-bone,  gave  some  trouble,  a  considerable  portion 
having  to  be  cut  and  scraped,  and  the  sinus  in  it  gouged 
out;  but  its  complete  removal  did  not  appear  to  be  called 
for. 

'  There  was  little  if  any  haemorrhage  until  release  of  the 
tourniquet,  when  the  whole  broad  surface  became  deluged 
with  blood,  three  or  four  small  arteries  spurting  and  veins 
flowing  in  all  directions,  so  much  so  that  I  was  glad  to 


Fig.  113. — Chronic  Coronitis  following  'Tread.' 

refix  the  clasp,  and  with  the  firing-iron  seal  up  the  vessels, 
searing  gently  all  over  the  surface. 

'  A  good  dusting  with  antiseptic  powder,  a  thick  pad  of 
carbolized  wool,  and  two  long  calico  bandages  wound 
tightly  round,  completed  the  work. 

'  The  other,  the  near-leg,  was  then  dealt  with  in  the 
same  way. 

'  The  mass  removed  weighed  a  little  over  9J  pounds — 


WOUNDS  245 

5  pounds  from  the  off-foot  and  4J  pounds  from  the  near. 
Its  structure  was  fibrous  tissue,  almost  as  firm  and  hard  as 
cartilage,  and  with  no  appearance  of  malignancy. 

'  The  after-treatment  consisted  simply  of  fresh  dry 
dressings — copper,  sulphate,  zinc  sulphate,  and  calamine, 
equal  parts — applied  every  third  or  fourth  day,  after  first 
bathing  the  feet  in  a  shallow  tub  of  warm  antiseptic  water. 

'  At  the  end  of  eight  or  ten  weeks  a  fairly  presentable 
appearance  existed.  The  greater  part  of  what  had  been 
raw  surface  was  covered  with  healthy  skin,  and  the  re^ 
mainder  had  become  dry  and  horny.'  * 

A  further  form  of  chronic  coronitis  is  that  shown  in 
Fig.  113. 

This  condition  is  commonly  the  result  of  a  severe  and 
jagged  tread  with  the  calkin,  and  takes  the  form  of  an 
ulcerous  and  excessively  granulating  wound.  As  time  goes 
on  the  granulations  become  hard  and  horny-looking,  and 
their  fibrous  tissue  as  hard  and  unyielding  as  tendon  or 
cartilage. 

These  if  treated  in  the  early  stages  with  repeated  dress- 
ings of  caustic,  or,  if  very  exuberant,  the  use  of  the  knife, 
usually  yield  to  treatment.  If  negletced  until  the  condition 
depicted  in  the  figure  is  arrived  at,  then  treatment,  as  a 
rule,  is  of  no  avail.  Neither  is  treatment  of  any  use  if  any 
great  loss  of  the  coronary  cushion  has  occurred. 

D.    FALSE  QUARTER. 

Definition. — False  quarter  is  the  term  applied  to  that 
condition  of  the  horn  of  the  quarter  in  which,  owing  to 
disease  or  injury  of  the  coronet,  the  wall  is  grown  in  a 
manner  that  is  incomplete. 

Symptoms. — This  condition  of  the  foot  appears  as  a  gap 
or  shallow  indentation,  narrow  or  wide,  in  the  thickness  of 
the  wall,  with  its  length  in  the  direction  of  the  horn  fibres. 
By  this  we  do  not  mean  that  the  sensitive  laminae  are  bared 
and  exposed.  Horn  of  a  sort  there  is,  and  with  this  the 
sensitive  structures  are  covered.     Running  down  the  centre 

*  Veterinary  Record,  vol.  xiv.,  p.  201  (C.  Cunningham,  M.R.C.V.S.). 


246         DISEASES  OF  THE  HORSE'S  FOOT 

of  the  incomplete  horn  is  usually  a  narrow  fissure  marking 
the  line  of  separation  in  the  papillary  layer  of  the  coronary 
cushion,  which,  as  we  shall  later  see,  is  responsible  for  the 
malformation. 

On  either  side  of  the  indentation,  as  if  wishing  to  aid 
further  than  ordinarily  it  should  in  bearing  the  body- 
weight,  the  horn  takes  on  an  increased  growth,  and 
stands  above  the  level  of  the  horn  surrounding  it.  It 
may,  as  perhaps  it  really  is,  be  regarded  as  a  form  of 
hypertrophy,  brought  about  by  the  increased  work  that 
the  loss  of  substance  in  the  region  of  the  false  quarter  puts 
upon  it. 

So  long  as  the  sensitive  structures  are  protected  the 
animal  remains  sound.  Sometimes,  however,  from  the 
effects  of  concussion  or  of  the  body-weight,  a  fissure  ap- 
pears in  the  narrow  veneer  of  horn  that  covers  them. 
Into  this,  which,  of  course,  is  but  a  form  of  sand-crack, 
gravel  and  dirt  penetrate,  and  so  set  up  inflammatory 
changes  in  the  keratogenous  membrane.  As  a  result 
suppuration  ensues,  and  the  animal  is  lame. 

Causes. — False  quarter  may  result  from  any  disease  of 
the  foot  that  involves  destruction  of  a  portion  of  the 
coronary  cushion.  As  we  may  see  from  a  reference  to 
Chapter  III.,  it  is  from  the  papillae  of  this  body  that  the 
horn  tubules  of  the  wall  are  secreted.  Destruction  of  any 
portion  of  it  necessarily  results  in  a  corresponding  loss  of 
horn  in  that  position.  The  disease  occasioning  this  more 
often  than  any  other  is  perhaps  quittor.  It  may  also  result 
from  suppurating  corn,  from  a  severe  tread  or  overreach, 
or  from  the  effects  of  a  slowly  progressing  suppurating 
coronitis. 

Treatment. — A  radical  treatment  of  false  quarter  is  not 
to  be  found.  Once  destruction  of  the  secreting  layer  of 
the  coronary  cushion  has  occurred,  the  appearance  of  the 
fissure  in  the  wall  will  always  have  to  be  reckoned  with.  A 
false  quarter,  therefore,  not  only  renders  the  horse  liable  to 
occasional  lameness,  but  also  renders  weaker  that  side  of 
the  hoof  in  which  it  occurs. 


WOUNDS  247 

The  only  method  of  treatment  that  can  be  practised, 
therefore,  is  that  of  palliation.  Seeing  that  the  trouble  the 
veterinary  attendant  will  have  to  deal  with  is  loss  of  a 
portion  of  the  weight-bearing  surface,  his  attention  is  im- 
mediately directed  to  the  shoeing.  As  with  sand-crack,  so 
with  false  quarter,  the  frog  and  the  bars  must  be  called 
upon  to  take  more  of  the  body-weight  than  commonly  they 
do  with  the  ordinary  shoe.  The  indication,  then,  is  a  bar 
shoe.  At  the  same  time,  the  bearing  of  the  wall  on  the 
shoe  on  either  side  of  the  fissure  should  be  eased  by  slightly 
paring  it,  and  the  hypertrophied  horn  on  the  outer  surface 
of  the  wall  removed  with  the  rasp. 

In  cases  where  penetration  of  the  sensitive  structures 
has  occurred,  complicated  with  the  formation  of  pus,  the 
same  treatment  as  for  complicated  crack  is  to  be  followed. 
The  foot  should  be  poulticed  for  several  days  with  hot  anti- 
septic dressings,  and  thorough  cleansing  of  the  infected 
parts  brought  about.  Afterwards  strong  solutions  of  suit- 
able antiseptics  should  be  applied  daily  until  such  time  as 
the  horny  covering  has  renewed  itself.  This  done  and  the 
bar  shoe  applied,  the  fissure  may  be  plugged  with  any 
effectual  stopping.  Either  a  mixture,  such  as  Percival's,  of 
pitch  2  parts,  tar  1  part,  and  resin  1  part,  melted  and 
mixed  together,  or  one  of  the  artificial  hoof-horns  may 
either  be  used  with  advantage. 

E.    ACCIDENTAL   TEAEIXG   OFF   OF   THE   ENTIRE 
HOOF. 

Causes. — Seeing  that  this  accident  to,  and  consequent 
severe  wounding  of,  the  keratogenous  membrane  nearly 
always  occurs  in  but  one  way.  it  is  worthy  of  special  men- 
tion. So  far  as  we  are  able  to  ascertain,  it  is  an  accident 
peculiar  to  horses  continually  engaged  in  shunting  opera- 
tions either  in  pits  or  station-yards.  At  the  moment  the 
animal  is  released  from  the  waggon  he  has  been  pulling, 
and  should  turn  to  the  right  or  the  left  in  order  to  allow  it 
to  pass  him,  the  shoe  either  becomes  wedged  in  between  two 
converging  rails,  or  is  trapped  by  the  wheel  of  the  waggon. 


248         DISEASES  OF  THE  HORSE'S  FOOT 

Either  the  approaching  waggon  with  the  added  weight  its 
impetus  gives  it  then  pushes  the  animal  suddenly  away, 
leaving  a  part  of  his  foot  still  fixed  to  the  rails,  or  the 
animal  himself,  feeling  securely  held,  makes  a  sudden  effort 
to  release  himself,  and  draws  his  foot  cleanly  out  of  the 
imprisoned  horny  box. 

The  author  calls  to  mind  a  case  in  which  entire  removal 
of  the  horn  of  the  foot  of  an  ox  occurred  through  the  pass- 
ing over  it  of  t  he  wheel  of  a  heavily-laden  cart.  It  is  there- 
fore quite  conceivable  that  the  same  accident  might  occur 
to  the  horse,  As  a  matter  of  fact,  we  find  one  case  on 
record  where  one-half  of  the  horny  box  was  thus  removed.* 

So  far  as  we  are  able  to  gather,  it  is  more  a  result  of  im- 
prisonment of  the  shoe  than  of  the  foot.  It  appears,  further, 
to  be  always  a  result  of  the  animal  being  newly  shod,  and 
the  clinches  firmly  secured;  so  much  so  that  it  would  be 
probable,  with  imperfectly  secured  clinches,  that  the  animal 
would  draw  the  hoof  from  the  clinches  and  the  shoe  rather 
than  the  foot  from  its  horny  covering. 

Therefore,  as  the  author  of  one  of  the  cases  we  shall 
afterwards  relate  suggests,  it  should  be  proposed  as  a  pre- 
ventive that  the  shoe-nails  of  animals  regularly  engaged  in 
work  on  the  metals  should  not  be  clinched  in  the  regulation 
manner,  but  should  have  their  points  merely  screwed  off, 
and  the  nails  afterwards  rasped  level  with  the  wall. 

These  cases  are  particularly  interesting  as  illustrating 
the  rapid  manner  in  which  a  new  hoof  is  afterwards  formed, 
and  the  way  in  which  the  exposed  sensitive  laminae  take 
their  share  in  adding  to,  though  not  forming  the  bulk  of, 
the  horn  of  the  wall. 

From  the  cases  we  are  able  to  record  it  will  be  seen  that 
this  accident  need  not  be  looked  upon  as  fatal,  nor  the 
injury  itself  beyond  hope  of  repair.  Dependent  largely 
upon  the  temperament  of  the  animal,  the  amount  of  pain 
that  is  caused,  and  the  way  in  which  the  animal  bears  it, 
recovery  may  be  looked  for.  Even  from  the  very  com- 
mencement of  the  accident,  however,  the  pain  may  be  so 

*  Veterinary  Record,  vol.  xiii.,  p.   129. 


WOUNDS  249 

acute  and  the  animal  so  violent  with  it  that  slaughter  be- 
comes necessary. 

Treatment. — This  consists  in  applying  an  antiseptic  and 
sedative  dressing  to  the  injured  parts  (for  example,  Car- 
bolized  Oil  and  Tincture  of  Opium,  equal  parts)  and  after- 
wards bandaging. 

From  the  only  data  we  are  able  to  work  on,  it  appears 
that  this  dressing  should  be  repeated  daily,  the  bandage 
being  removed  each  time,  the  foot  well  bathed  in  warm 
water,  and  the  dressing  and  bandage  afterwards  replaced. 
On  first  sight,  it  would  appear  that  once  cleansed  and 
bandaged  the  dressings  might  be  left  in  situ  for  several 
days.  Seeing,  however,  that  suppuration,  if  once  set  up, 
would  add  further  to  the  intense  pain  the  animal  is  already 
suffering,  and  considering  the  always  constant  exposure  of 
the  foot  to  infection,  it  is  perhaps  wise  to  persist  in  daily 
changing  of  the  dressings. 

At  the  same  time,  the  general  health  of  the  animal  should 
be  attended  to.  Suitable  febrifuges  should  be  administered, 
either  in  the  shape  of  a  dose  of  physic,  or  salines  and  liq. 
ammonia,  acetatis ;  and  the  pain,  if  appearing  unbearable, 
allayed  by  doses  of  choral  and  hypodermic  injections  of 
morphia. 

Recorded  Cases. — 1.  '  A  short  time  ago  I  was  called  to 
see  a  horse  which  had  had  his  hoof  torn  off  in  a  railway 
"  point."  When  I  arrived  at  the  stable  the  injury  had  been 
done  two  hours,  and  the  horse  had  been  led  from  the  rail- 
way to  a  loose-box  nearly  half-a-mile  off.  On  going  to  this 
box  I  was  surprised  and  horrified  to  find  the  poor  animal 
mad  with  pain,  rolling  and  dashing  himself  about.  When 
on  his  back  he  would  struggle  and  kick  the  walls  with  the 
injured  foot,  as  though  unconscious  of  pain.  Not  one 
moment  was  he  still,  and  as  I  could  see  that  the  sensitive 
structures  were  much  damaged  by  his  violence,  I  obtained 
a  gun  and  put  him  out  of  his  pain. 

'  The  accident  happened  in  this  way.  The  horse  was 
employed  in  shunting  coal-waggons,  and  had  just  drawn 
four  loaded  trucks  up  to  a  point  at  which  they  diverged  to 


250        DISEASES  OF  THE  HORSE'S  FOOT 

the  left,  and  the  horse,  being  unhooked,  ought  to  have 
turned  to  the  right.  Here,  unfortunately,  the  near  fore- 
foot became  wedged  in  between  two  converging  railway 
plates,  one  of  which  formed  a  part  of  the  waggon-way,  on 
which  the  trucks  were  running.  The  horse  was  a  big 
animal,  and  freshly  shod  with  heavy  shoes,  on  which  a  toe- 
piece  and  calkins  were  used.  The  shoe  was  roughly  but 
strongly  nailed  on  with  eight  nails,  the  clinches  of  which 
were  all  firm.  This  shoe  was  fitted  wide  at  the  heels,  and 
when  the  foot  was  fixed  in  the  points  (toe  downwards)  it 
protruded  over  the  face  of  the  rail.  When  the  trucks 
reached  it  they  pressed  it  down,  and,  the  horse  leaning  for- 
ward, the  hoof  was  drawn  off  like  a  glove.  The  hoof  was 
almost  as  clean  inside  as  if  taken  off  by  maceration — only 
towards  the  toe  was  a  small  portion  of  the  coffin-bone  and 
some  torn  laminae  left  inside  the  hoof. 

'  As  soon  as  possible  after  the  accident,  so  I  was  told,  the 
foot  was  bound  up  with  tow  and  a  bandage ;  then  a  sack 
was  cut  up  and  placed  over  all,  and  the  horse  slowly  led  to 
his  loose-box.  He  "  carried  "  the  leg  all  the  way,  limping 
along  on  the  three  sound  ones.  Almost  immediately  after 
reaching  the  box  he  lay  down,  but  only  for  a  short  time. 
The  standing  position  was  not  long  maintained — profuse 
perspiration  set  in,  and  the  alterations  of  position  became 
more  rapid  and  violent,  till  plunging  and  rolling  were  added 
to  the  other  signs  of  excruciating  pain.  I  was  also  told 
that  the  groaning  of  the  poor  animal  was  almost  constant, 
and  at  times  so  loud  and  prolonged  as  to  amount  to  a  shriek. 

'  I  have  no  experience  of  a  similar  case,  and  I  should  not 
have  supposed  that  this  accident  would  have  caused  such 
acute  suffering  and  violent  symptoms.  I  think  I  have  heard 
of  such  cases  making  a  complete  recovery ;  but  I  feel  sure 
that,  in  this  case,  I  only  anticipated  death  by,  at  most,  a 
few  hours.'  * 

2.  '  The  case  I  am  about  to  give  you  an  account  of,  being 
one  of  rare  occurrence,  I  thought  would  not  prove  un- 
interesting to  the  members  of  the  Veterinary  Medical 
*  Veterinary  Record,  vo.  iv.,  p.   127. 


WOUNDS  251 

Association.     It  is  an  instance  of  complete  removal  of  the 
hoof  by  mechanical  force. 

'  Our  patient  was  a  brown  mare,  five  years  old,  the 
property  of  Messrs.  Crawshaw  and  Co.,  railway  contractors 
on  the  Sheffield  and  Manchester  line. 

'  On  June  20  the  mare  was,  as  usual,  working  on  the  line, 
drawing  one  of  the  waggons  for  the  removal  of  soil  from 
one  place  to  another,  and,  as  was  the  custom,  the  pace  is 
generally  increased  at  about  the  distance  of  from  sixty  to 
eighty  yards  from  where  the  unloading  takes  place,  in  order 
to  add  to  the  velocity,  so  that  the  contents  of  the  waggons 
might  roll  down  so  great  a  precipice.  It  was  at  this 
increased  action,  when  the  mare  wTas  being  removed  from 
the  waggon,  that  she  stepped  between  the  ends  of  two  iron 
rails,  sufficiently  apart  to  admit  the  foot  only,  when  one  end 
of  the  rail  inserted  itself  between  the  sole  and  toe  of  the 
shoe,  the  other  at  the  top  and  in  front  of  the  crust. 

'  The  mare,  finding  herself  fixed,  endeavored  to  disengage 
herself,  and,  in  doing  so,  got  in  front  of  the  waggon,  which, 
coming  at  a  great  pace,  forced  her  down  into  the  pit,  leaving 
behind  the  off  fore-hoof,  which  was  only  removed  from  its 
situation  between  the  two  rails  by  a  large  hammer,  it  being 
so  firmly  wedged  in.  The  shoe  and  hoof  were  bent  in  a 
very  peculiar  manner,  as  the  accompanying  cuts  will  show, 
the  inside  heel  being  completely  raised  from  above  the  level 
of  the  frog,  not  one  of  the  nails  being  unclenched,  or  in  the 
slightest  degree  having  given  way  to  so  large  an  amount  of 
force  imposed  upon  them,  although  the  toe  of  the  shoe  was 
raised  from  the  sole  by  the  rail  being  immediately  under  it 
(see  Fig.  114).  The  mare  had  been  shod  the  day  before, 
and,  having  a  good  sound  foot,  the  shoe  was  firmly  put  on. 
'  Being  a  mile  from  home,  she  was  with  some  difficulty 
made  to  travel  that  distance.  On  her  arrival,  my  precep- 
tor, Mr.  Taylor,  was  immediately  sent  for,  who  found  her, 
as  I  have  before  stated,  with  the  off  fore-foot  hoofless. 

'  Proceeding  to  examine  the  foot,  he  ascertained  that  it 
had  bled  considerably,  which,  however,  was  stopped  by 
bandages   to   the    foot   and   a   ligature   round   the   coronet. 


252        DISEASES  OF  THE  HORSE'S  FOOT 

The  laminae  on  one  side  and  a  small  portion  of  the  sensitive 
sole,  though  not  to  any  great  extent,  were  lacerated.  The 
coffin-bone  was  not  at  all  injured.  The  bleeding  having 
nearly  ceased,  she  was  put  into  slings,  the  foot  carefully 
washed  with  warm  water,  and  immediately  bound  up  with 
pledgets  of  tow  saturated  with  the  simple  tincture  of  myrrh 
and  tincture  of  opium,  of  equal  parts. 


Fig.  114. — Hoof  Torn  from  the  Foot  by  Accident. 

'  The  dressing  was  ordered  to  be  allowed  to  remain  on  all 
night,  and  on  the  following  morning  to  be  removed.  The 
foot  was  then  bathed,  as  before,  in  warm  water,  and  the 
application  of  the  tinctures  repeated  night  and  morning. 
The  medicine  internally  given  was  castor  oil,  with  tinct. 
opium,  and  this,  in  a  diminished  dose,  was  ordered  the 
next  morning.     Blood  was  also  abstracted  from  the  jugular 


WOUNDS  253 

vein,  to  the  amount  of  6  quarts,  so  as  to  allay  the  inflam- 
matory fever  set  up.  The  food  consisted  of  bran  and 
linseed,  with  small  portions  of  hay  and  water.  The  mare 
being  in  a  highly  excited  state,  and  suffering  such  severe 
pain,  the  opinion  Mr.  Taylor  gave  was  that,  should  she  get 
over  the  first  four  days  (which  appeared  quite  uncertain), 
he  had  no  doubt  of  her  ultimately  getting  well,  and  also 
that  she  would  have  a  perfect  hoof  formed.  It  was  now 
left  for  the  owners'  consideration,  whether  they  thought  the 
mare  worth  her  keep  till  such  took  place,  the  time  men- 
tioned by  Mr.  Taylor  being  four  or  five  months.  She  was 
seen  again  the  fourth  day  after  the  accident,  and  was  then 
found  to  be  perfectly  tranquil  and  feeding  well ;  her  pulse, 
which  at  the  first  visit  could  not  be  counted,  was  now  not 
more  than  65  beats  in  the  minute.  On  removing  the 
dressings,  the  foot  presented  a  very  favourable  appearance, 
the  treatment  therefore  varied  only  in  the  application  of  a 
linseed-meal  poultice  over  the  former  dressings  of  tinctures 
of  opium  and  myrrh,  confining  the  whole  in  a  soft  leather 
boot.  Diet  as  before,  in  addition  to  which  give  a  few  oats. 
Should  the  bowels  become  constipated,  repeat  the  castor 
oil  without  the  opium. 

'  June  28. — The  animal  was  again  seen,  and  appeared  to 
be  going  on  very  favourably.  The  poultices  were  directed 
to  be  discontinued,  and  the  parts  dressed  every  other  day 
with  sol.  sulph.  cupri,  as  the  granulations  were  getting 
luxuriant. 

'  July  6. — To-day  she  was  found  to  have  gone  on  so  well, 
having  two  days  before  been  removed  from  the  slings,  that 
it  was  thought  justifiable  to  turn  her  out,  protecting  the 
foot  with  a  boot,  and  ordering  the  dressings  to  be  repeated. 

'  July  23. — She  was  seen  by  me  in  the  field,  where  I  had 
the  boot  removed,  and  so  much  had  she  improved,  that  not 
less  than  2  inches  of  crust,  proceeding  from  the  coronary 
ring,  had  been  formed,  and  the  foot  looked  remarkably 
healthy. 

1  It  will  be  seen  that  the  accident  occurred  on  June  20,  a 
fortnight  after  which  time  I  observed  the  horny  crust  to  be 


254         DISEASES  OF  THE  HORSE'S  FOOT 

forming  from  the  coronet,  and  the  insensitive  laminae  at 
the  same  time,  in  which  on  every  visit  an  increase  of 
growth  was  perceptible,  and  it  soon  attained  a  thickness 
exceeding  that  of  the  other  hoof,  bnt  which  at  the  same 
time  presented  a  more  upright  appearance.  It  was  not  until 
three  weeks  after  our  first  visit  that  any  formation  of  new 
sole  or  frog  was  to  be  seen.  Of  the  two  the  sole  was  the 
first,  being  secreted  by  the  sensitive  sole,  the  growth  pro- 


Fig.   115. — Hoof  Torn  from  the  Foot  by  Accident. 

ceeding  from  the  heels.     In  like  manner  the  insensitive  frog 

was  being  produced  by  the  sensitive. 

'  During  the  last  week  in  October  the  mare,  having  her 
foot  protected  with  a  bar  shoe  plated  at  the  bottom,  and  so 
formed  as  to  open  without  necessity  of  removing  the  shoe, 
in  order  to  facilitate  the  applications  of  the  tinctures,  was 
put  to  light  work,  which  has  since  been  gradually  increased, 
and  she  now  performs  her  usual  labour  equal  to  any  other 
horse. 

'  The  growth  of  the  wall  or  crust  and  insensitive  laminae 
is  not  yet  quite  complete,  nor  is  the  sole,  there  being  want- 


WOUNDS  255 

ing  about  an  inch  of  the  horny  substance  of  it,  Lhe  entire 
completion  of  which  1  should  rather  doubt,  as  I  mentioned 
in  my  former  communication  that  the  sensitive  lamina.1 
and  a  small  portion  of  the  sole  were  lacerated,  and  it  is  in 
these  parts  that  the  imperfections  exist. 

'  The  yet  imperfectly-formed  wall  not  admitting  of  the 
insertion  of  nails  all  around  it,  the  shoe  is  held  on  partly 
by  nails  and  partly  by  a  -trap  attached  to  it  bound  round 
the  coronet."  :; 

3.  '  This  case  is  related  by  Mr.  A.  Rogerson,  F.R.C.V.S. 
It  occurred  to  an  animal  regularly  engaged  in  shunting, 
and  happened  through  the  comer  of  the  shoe  becoming 
"  trapped  "  between  a  line  of  metal  and  the  wheel  of 
truck.  It  is  particularly  interesting  on  account  of  the 
photograph  accompanying  it,  and  which  we  here  reproduce 
in  Fig.  115. 

'  The  photograph  shows  plainly  the  manner  in  which  the 
holding  of  the  "  clinches  "  on  the  left  side  of  the  hoof  has 
resulted  in  drawing  it  off  from  the  foot.  Had  these 
clinches,  as  Mr.  Rogerson  suggests,  been  left  unfastened, 
then  the  accident  in  all  probability  would  not  have  occurred. 

*  Veterinary  Record,  vol.  iv.,  p.  182   (B.  Cartledgc). 
t  Ibid.,  vol.  xiii.,   p.  2. 


CHAPTER  IX 

INFLAMMATORY  AFFECTIONS  OF  THE  KERA- 
TOGENOUS  APPARATUS 

A.    ACUTE. 
Acute  Laminitis. 

Definition. — The  term  'laminitis'  is  vised  to  indicate  a 
spontaneous  and  diffuse  inflammation  of  the  whole  of  the 
sensitive  structures  of  the  foot,  more  particularly  the  sensi- 
tive laminae.  Usually  it  occurs  in  the  two  front  feet,  often 
in  all  four,  and  occasionally  in  the  hind  alone. 

Causes. — In  dealing  with  the  causes  of  laminitis,  we  will 
first  dispose  of  those  coming  under  the  heading  of  trau- 
matic., Correctly  speaking,  however,  lesions  of  the  laminae 
thus  occurring  do  not  present  the  same  symptoms,  nor  run 
an  identical  course  with  the  disease  we  now  purpose  de- 
scribing, and  for  which  we  would  prefer  to  entirely  reserve 
the  term  '  laminitis.'  The  fact,  however,  that  traumatic 
causes  are  detailed  in  other  works  on  the  same  subject 
compels  us  to  give  them  mention  here. 

Strictly  traumatic  causes  giving  rise  to  a  limited  inflamma- 
tion of  the  sensitive  laminae  are  violent  blows  upon  the  foot, 
either  purely  accidental,  or  self-inflicted  by  violent  kicking. 

A  similar  limited  laminitis  is  to  be  found  in  the  condi- 
tions we  have  described  under  '  Nail-bound  and  Punctured 
Foot.'  It  is  met  with  also  in  the  injuries  resulting  from 
tread  and  overreach,  and  in  the  tissue-changes  accompany- 
ing corn. 

256 


INFLAMMATORY  AFFECTIONS  257 

The  tenderness  following  upon  excessive  hammering  in 
the  forge,  or  of  too  long  an  application  of  the  shoe  in  hot- 
fitting  has  also  been  described  as  laminitis. 

With  either  of  the  conditions  we  have  mentioned,,  it  goes 
without  saying  that  there  is  either  a  simple  congestion  or 
an  actual  inflammation,  localized  or  general,  of  the  laminae 
of  the  injured  foot.  In  neither  case,  however,  can  the 
resulting  mischief  be  closely  compared  with  the  lesions 
attending  an  attack  of  laminitis  proper,  a  disease  which 
appears  to  have  an  almost  specific  cause,  and  to  run  a 
course  peculiarly  its  own. 

The  specific  cause  we  have  indicated  as  existing  can,  in 
the  present  state  of  our  knowledge,  be  only  vaguely  de- 
scribed as  a  poisoned  state  of  the  blood-stream.  This,  as 
clinical  evidence  teaches  us,  may  result  from  a  variety  of 
causes. 

Among  these,  by  far  the  most  common  is  that  state  of 
the  circulation  induced  by  excessive  feeding  with  too  stimu- 
lating or  too  irritating  a  diet.  In  any  case,  where  the  use 
of  old  oats  as  a  staple  diet  is  departed  from,  and  where  the 
quantity  and  manner  of  using  the  substitute  is  left  to  the 
discretion  of  careless  or  unskilled  attendants,  trouble  is 
likely  to  ensue.  The  food  more  prone,  perhaps,  than  any 
other  to  bring  about  an  attack  is  wheat  improperly  pre- 
pared— that  is,  uncooked  or  unground.  So  much  so  is  this 
the  case  that  one  full  meal  of  this  provender  to  an  animal 
unused  to  it  is  sufficient  to  lead  to  a  train  of  symptoms 
often  ending  fatally. 

Beans,  peas,  barley,  rye,  new  maize,  or  even  new  oats, 
are  all  liable,  if  carelessly  used,  to  have  the  same  effect. 

It  is  the  laminitis  following  feeding  on  new  oats  that  has 
caused  us  to  apply  to  the  food  the  adjective  '  irritating.' 
Here,  more  often  than  not,  the  peristaltic  action  of  the 
bowels  is  found  to  be  abnormally  in  evidence,  and  the  ex- 
cessive use  of  the  diet  is  always  accompanied  by  a  more  or 
less  fluid  discharge  of  the  intestinal  contents. 

In  addition  to  the  foods  we  have  mentioned,  many  others 
might  be  enumerated,  more  especially  the  numerous  '  made- 


258         DISEASES  OF  THE  HORSE'S  FOOT 

up  '  feeding  materials  now  on  the  market.  Many  are  com- 
posed of  substances  that  may  be  regarded  as.  absolutely 
opposed  to  the  correct  feeding  of  a  horse,  and  their  use  can 
only  be  followed  by  this  and  other  evil  results. 

Another  most  fruitful  cause  of  laminitis  is  a  severe  and 
continued  inflammatory  condition  of  the  system  elsewhere. 
It  is  the  laminitis  known  to  veterinary  surgeons  as  '  metas- 
tatic,' and  perhaps  the  two  most  notable  examples  of  it  are 
the  laminitis  following  a  prolonged  attack  of  pneumonia, 
and  the  '  Parturient  Laminitis  '  occurring  as  a  concomitant 
of  septic  metritis. 

Parturient  laminitis  it  is  that  offers  us  the  most  striking 
illustration  of  the  truth  that  a  poisoned  state  of  the  blood- 
stream is  a  sure  factor  in  the  causation  of  an  attack.  From 
the  direct  evidence  of  our  senses  (namely,  manual  explora- 
tion of  the  infected  womb,  and  the  stench  of  the  exuding 
discharge)  we  know  that  we  have  in  the  interior  of  the 
womb  matter  in  a  state  of  putrescence.  From  the  experience 
of  previous  post-mortems  we  know,  further,  that  the  putres- 
cent matter  thus  originating  often  gains  the  blood-stream,  and 
forms  foci  of  septic  lesions  elsewhere — liver  or  lung.  When, 
therefore,  during  an  attack  of  septic  metritis  a  condition  of 
laminitis  supervenes,  we  are  justified  in  attributing  it  to 
the  escape  of  septic  matter  from  the  already  infected  uterus. 

In  the  same  category  of  laminitis  from  metastasis  may 
also  be  placed  the  laminitis  occurring  as  a  result  of  an  over- 
dose of  aloes.  The  enteritis  thus  set  up  is  often  followed 
by  laminitis,  and  that  of  a  serious  type. 

Prolonged  and  excessive  work  upon  a  hard  road  is  also 
apt  to  induce  an  attack.  When  this  occurs  it  in  many 
cases  resolves  itself  into  a  case  of  cruelty.  (See  reported 
case,  No.  1,  p.  279.) 

Laminitis  from  this  cause  was  frequent  among  coach  and 
carriage  horses  in  the  pre-railroad  period,  and  resulted  from 
attempting  to  obtain  from  the  animal  a  faster  pace  and  a 
greater  number  of  miles  than  he  was  physically  capable  of 
giving. 

In  our  day,  however,  it  is  more  often  a  result  of  gross 


INFLAMMATORY   AFFECTIONS  259 

feeding,  combined  with  only  that  amount  of  work  which 
the  horse,  if  ordinarily  fed.  would  be  easily  able  to  perform. 
An  excellent  example  of  this  is  the  laminitis  occurring  in 
the  Shire  stallion  when  commencing  his  rounds  of  service 
in  the  spring  and  early  summer.  At  this  season  these 
animals  are  constantly  supplied  with  a  more  than  sufficient 
supply  of  a  highly  stimulating  and  nutritious  diet.  In  this 
case  the  blood  is  already  in  that  state  in  which  it  is  pre- 
disposed to  the  disease.  Add  to  this  the  unwonted  exercise 
— for  during  all  the  winter  the  animals  are  idle — and  con- 
gestion of  the  venous  apparatus  of  the  extremities  is  not  to 
be  wondered  at. 

Passing  from  these,  the  more  common,  we  may  consider 
ccher  and  less  frequent  causes  of  the  disease.  Congestion 
of  the  laminal  blood-vessels  and  consequent  laminitis  occurs 
when  animals  are  made  to  maintain  a  standing  position 
for  prolonged  periods,  as,  for  instance,  when  making  sea 
voyages.  A  long  and  painful  disease  of  one  foot,  neces- 
sitating the  whole  of  the  weight  being  borne  by  the  other, 
ends  often  in  laminitis  of  the  second  member.  It  may 
thus  occur  as  a  sequel  to  quittor.  complicated  sand-crack, 
suppurating  corn,  and  punctured  wounds  of  the  feet. 

Laminitis  has  also  been  known  to  occur  as  a  result  of 
septic  infection  of  the  blood-stream  consequent  on  the 
operation  of  castration.     (See  recorded  case,  Xo.  2,  p.  281.) 

A  sudden  lowering  of  the  surface  circulation  at  a  time 
when  the  animal  is  excessively  perspiring  is  also  said  to 
favour  an  attack,  as  also  is  the  giving  to  drink  of  cold  water 
to  an  animal  just  in  from  a  long  and  tiring  journey.  Also, 
according  to  Zundel,  '  the  influence  of  the  season  cannot 
be  denied,  and  it  is  during  the  summer  months  that 
laminitis  is  more  frequent,  while  it  is  rare  in  winter,  as 
well  as  in  the  spring  and  autumn.' 

Further,  laminitis  has  been  described  as  occurring  when 
the  animal  is  at  grass,  and  when  all  causes — at  any  rate, 
active  ones — have  appeared  to  be  absent.  (See  reported 
case,  Xo.  3,  p.  282.) 

Regarding  heredity,  we  may  safely  say  that,  as  a  cause 


260        DISEASES  OF  THE  HORSE'S  FOOT 

of  laminitis,  it  may  be  almost  totally  disregarded.  That 
a  bad  form  of  foot,  either  a  flat-foot  or  a  foot  with  heels 
contracted,  and  already  thus  affected  with  a  mild  type  of 
inflammation,  did  not  offer  a  certain  predisposition,  we 
should  not  like  to  assert.  There  must,  however,  be  an 
exciting  cause — namely,  a  poisoned  condition  of  the  blood- 
stream. This  latter  cannot,  of  course,  be  in  any  way 
regarded  as  hereditary. 

In  short,  the  dietetic  cause  is  by  far  the  most  common, 
and,  in  prosecuting  inquiries  as  to  the  starting-point  of  an 
attack,  the  veterinarian's  attention  should  be  directed  in 
the  main  to  that  particular. 

Symptoms. — Laminitis  is  always  ushered  in  by  a  set  of 
symptoms  indicative  of  a  high  state  of  fever.  The  pulse 
is  raised  from  the  normal  to  as  many  as  80  or  90  a  minute, 
muscular  tremors  are  in  evidence,  the  respirations  are  short 
and  hurried,  and  the  temperature  rises  to  105°,  106°,  or 
170°  F.  The  visible  mucous  membranes  are  injected,  that 
of  the  eye,  in  addition  to  the  hyperemia,  often  tinged  a 
dirty  yellow.  The  mouth  is  dry  and  hot,  the  urine  scanty, 
and  the  bowels  frequently  torpid.  As  yet,  however,  the 
walk  is  sound. 

Called  in  during  this  early  stage,  the  veterinarian  is 
often  puzzled  as  to  the  exact  significance  of  the  symptoms. 
Enteritis,  lymphangitis,  or  pneumonia  he  knows  to  be  often 
heralded  in  the  same  manner.  In  this  connection,  Zundel 
says :  '  Laminitis,  in  most  instances,  is  preceded  by  certain 
general  symptoms,  such  as  are  premonitory  of  the  invasions 
of  ordinary  inflammatory  diseases,  but  of  an  uncertain 
significance.' 

So  far  we  agree  with  him,  but  to  what  we  have  already 
said  we  would  add  that,  even  in  this  early  stage,  there  is  an 
additional  symptom,  unmentioned  by  Zundel,  which  often 
leads  one  to  an  exact  diagnosis.  The  feet  are  in  turn  lifted 
a  short  distance  from  the  ground,  and  almost  immediately 
replaced.  This  movement  ('  paddling  '  we  may  term  it)  is 
constant,  the  animal  appearing  to  obtain  ease  in  no  one 
position  for  more  than  a  few  moments  at  a  time. 


INFLAMMATORY  AFFECTIONS  261 

Seen  but  a  few  hours  later,  when  the  swelling  caused  by 
the  hyperemia  and  outpouring  of  the  inflammatory  exudate 
has  led  to  compression  of  the  sensitive  structures  within 
the  horny  box,  the  symptoms  presented  admit  of  no  mis- 
reading, save  by  the  most  casual  and  careless  observer. 
The  patient  now  stands  as  though  fixed  to  the  ground.  The 
pulse  is  hard  and  frequent,  the  respirations  tremendously 
increased  in  number,  the  body  wet  with  a  patchy  perspira- 
tion, and  the  countenance  indicative  of  the  most  acute 
suffering.  Only  with  difficulty,  and  often  only  at  the 
instigation  of  the  whip,  can  the  animal  be  induced  to  move. 
This  he  does  by  throwing  his  weight,  so  far  as  he  is  able, 
on  to  the  heels  of  the  feet  affected,  and  putting  the  feet 
slowly  forward  in  a  shuffling  and  feeling  manner.  The  feet 
themselves  give  to  the  hand  a  sensation  of  abnormal  heat, 
percussion  upon  them  with  the  hammer  is  followed  by 
painful  attempts  at  withdrawal,  while  any  effort  we  may 
make  to  remove  one  foot  from  the  ground  is  useless,  so 
great  an  aversion  does  the  animal  show  to  placing  a  greater 
weight  upon  the  opposite  foot. 

According  as  the  front-feet  alone,  the  hind-feet  alone,  or 
all  four  feet  are  affected,  the  symptoms  will  vary. 

With  all  four  feet  diseased,  the  animal  stands  with  the 
two  front-feet  extended  in  front  of  him,  while  the  hind- 
limbs  are  at  the  same  time  propped  as  far  beneath  him  as 
is  possible.  The  horse  is,  in  fact,  standing  upon  the  extreme 
hindermost  portions  of  the  feet. 

Why  the  animal  should  thus  distribute  his  weight  is 
easily  explained.  Standing  in  the  normal  position,  the 
body-wTeight  is  borne  by  the  sensitive  laminae,  the  sole,  of 
course,  sharing  in  the  burden,  but  the  laminae  taking  by 
far  the  greater  part  of  the  pressure  thus  exerted.  With  the 
vessels  of  the  laminae  gorged  with  blood,  and  the  laminal 
connective  tissue  infiltrated  with  a  profuse  inflammatory 
exudate,  the  most  excruciating  pain  is  bound  to  result  by 
reason  of  the  compression  of  the  diseased  tissues  with 
the  non-yielding  structures.  In  some  little  measure  the 
suffering  animal  may  afford  himself  relief  by  partly  remov- 


262        DISEASES  OF  THE  HORSE'S  FOOT 

ing  pressure  from  the  fore-parts  of  the  hoof.  When  placing 
the  body-weight  behind,  the  pressure,  instead  of  falling 
upon  the  highly  sensitive  laminae,  is  directed  to  the  follicular 
and  fatty  tissues  of  the  plantar  cushion ;  from  there,  with 
only  a  small  portion  of  the  sensitive  sole  intervening,  to 
the  horny  frog,  and  from  thence  to  the  ground. 

The  same  distribution  of  weight  also  places  the  foot  in  a 
position  of  greatest  expansion,  thus,  by  giving  greater  room 
to  the  diseased  parts,  again  affording  relief  of  pressure  on 
tiie  inflamed  laminae,  while  it  at  the  same  time  relieves 
r  f  weight  the  foremost  portions  of  the  sensitive  sole. 

With  the  fore-feet  alone  attacked,  the  animal  affects 
exactly  the  same  position  of  standing  as  that  just  described. 
The  fore-feet  are  again  extended,  and  the  hind  propped  far 
beneath  him.  The  fore  extended,  in  order  to  obtain  the  relief 
occasioned  by  standing  on  the  heels ;  the  hind  in  this  case 
carried  forward  in  order  to  take  a  greater  share  of  the  body- 
w eight,  and  thus  relieve  the  congested  members  in  front. 

With  the  hind  only  attacked,  then  the  fore  and  the  hind 
feet  are  more  closely  approximated  than  in  the  normal 
position.  The  reason,  of  course,  is  that  the  hind-feet  are 
carried  forward  in  order  to  be  placed  upon  the  heels,  while 
the  fore  are  taken  backwards  to  relieve  the  hind  of  the 
body-weight. 

In  like  manner  the  movements  of  the  animal  will  vary 
with  the  feet  affected.  With  only  the  front-feet  diseased 
the  animal  is,  comparatively  speaking,  comfortable.  The 
hind- feet  take  the  weight,  and  the  animal  stands  for 
long  periods  together,  resting  alternately  first  one  fore-foot 
and  then  the  other,  moving  often  in  a  circle  of  which  his 
body  is  the  radius,  and  his  hind-limbs  the  centre.  If  urged 
to  move  forward,  then  immediately  his  countenance  and 
movements  manifest  the  pain  to  which  he  is  put.  Only 
with  reluctance  does  he  cause  the  fore-feet  to  take  weight. 
They  are  shuffled  forward  quickly  one  after  the  other,  so 
that  weight  may  not  be  placed  upon  them  for  one  instant 
longer  than  is  necessary,  and  the  hind-limbs  immediately 
brought  again  with  two  short,  awkward  movements  beneath 


INFLAMMATORY  AFFECTIONS  263 

the  body.  Progress  thus  takes  place  in  a  succession  of 
movements  'halt  hobble/  'half  jump.' 

Painful  though  this  may  appear,  progress  is  still  more 
difficult  when  the  hind-feet  alone  are  diseased.  Afraid  that, 
in  placing  his  fore-members  freely  forward,  he  will  add  to 
the  pain  in  his  hind,  the  walk  takes  place  in  a  series  of 
extremely  short  steps,  with  the  feet  more  or  less  closely 
approximated.  The  gait  is  thus  rendered  extremely  awk- 
ward, and  Zundel,  by  saying  that  '  the  animal  appears  as  if 
treading  on  sharp  needles.'  most  fitly  describes  it. 

Movement  with  all  four  feet  affected,  though  less  awk- 
v.ard  in  appearance,  is  doubtless  more  painful  than  in  either 
of  the  other  conditions.  Here  the  animal  can  hardly  be  in- 
duced to  shift  his  position  at  all.  Only  by  flogging,  and 
that  severe,  can  he  be  made  to  go  forward.  When  so 
induced  to  move,  the  agonizing  pain  to  which  the  patient  is 
subjected  may  be  gathered  by  noting  his  countenance  and 
manner  of  progression. 

With  each  movement  forward,  muscular  tremors  affect 
the  limbs;  each  step  is  short,  jerky,  and  convulsive;  the 
respirations  and  pulse  are  almost  immediately  greatly 
quickened,  and  the  lower  lip  is  hung  pendulous,  and  moved 
almost  unconsciously  up  and  down  with  a  flapping  noise 
against  the  upper.  A  patchy  perspiration  breaks  out  about 
the  body  and  quarters,  and  the  tail  is  outstretched  and 
quivering.  At  the  same  time  the  lines  of  the  face  become 
drawn,  the  commissures  of  the  lips  pulled  upwards,  the 
eves  staring  and  haggard,  the  eyelids  puckered,  the  nostrils 
extended,  and  the  whole  expression  indicative  of  the  intense 
and  agonizing  pain  of  the  disease. 

One  can  perhaps  better  give  one's  client  some  vague  idea 
of  the  patient's  suffering  by  likening  the  pain  to  the  throb- 
bing sensation  of  a  festered  finger-nail.  Tell  him  that  each 
hoof  of  the  horse  is  similarly,  or.  of  anything,  more  deli- 
otely,  constructed,  that  in  each  foot  the  same  process  of 
'  festering  '  is  going  on,  and  that  upon  them  the  animal  has 
perforce  to  stand. 

As  one  might  expect,  the  position  of  greatest  ease  is  the 


264        DISEASES  OF  THE  HORSE'S  FOOT 

decumbent.  Strange  to  say,  though,  in  many  cases  of 
laminitis  the  animal  persists  in  maintaining  a  standing 
posture.  Once  down,  however,  one  has  sometimes  the 
greatest  difficulty  in  persuading  him  again  to  rise.  The 
lying  position  is  so  long  maintained  that  bedsores  begin  to 
make  their  appearance,  and  the  animal  rapidly  loses  flesh, 
not  only  by  reason  of  the  fever  and  the  pain,  but  by  giving 
to  rest  the  time  he  should  normally  give  to  feeding. 

Difficulty  in  rising  is  greatest  when  all  four  feet  are 
affected;  is  nearly  as  great  when  the  hind-limbs  only  are 
in  trouble,  but  is  least  when  the  disease  exists  alone  in  the 
two  fore-feet. 

The  Course  of  the  Disease  and  its  Pathological 
Anatomy. — As  with  most  inflammations  of  any  severity,  so 
with  this  we  may  consider  the  pathological  changes  taking 
place  in  the  foot  under  three  headings :  (a)  The  period  of 
Congestion;  (b)  the  period  of  Exudation;  (c)  the  period  of 
Suppuration. 

(a)  Congestion. — In  the  early  stages  of  laminitis  there  is 
a  state  of  engorgement  of  the  vessels  of  the  keratogenous 
apparatus  generally,  but  more  particularly  the  laminal 
portion  of  it.  With  the  hoof  removed  at  this  stage  the 
sensitive  laminae  are  found  to  be  swollen,  dark  red  in 
colour,  and  affording  a  distinct  feeling  of  increased  thick- 
ness when  pressed  between  the  fingers.  Incised,  there 
escapes  from  the  cut  surface  a  large  flow  of  dark  venous- 
looking  blood.  At  this  stage  haemorrhages  of  the  laminal 
vessels  occur.  The  escaping  blood  infiltrates  the  surround- 
ing connective  tissue,  and  in  many  cases  destroys  the 
union  between  the  horny  and  sensitive  laminae.  This 
change  is  most  noticeable  in  the  region  of  the  toe  and  the 
commencement  of  the  quarters,  the  os  pedis  appearing  as 
though  pushed  backwards  by  the  escaping  fluid  collected 
between  the  wall  and  the  bone.  In  severe  cases,  fortunately 
but  rarely  seen,  the  blood  so  escaping  continues  to  infil- 
trate, and  separate  the  tissues  until  it  is  seen  to  be  freely 
oozing  at  the  region  of  the  coronet.  (See  reported  case, 
No.  1,  p.  279.) 


INFLAMMATORY  AFFECTIONS  265 

(b)  Exudation. — The  period  of  exudation  marks  the  out- 
pouring of  the  inflammatory  fluid.  This,  even  more  than 
the  haemorrhages  attending  the  stage  of  congestion,  tends 
to  destroy  the  intimacy  between  the  sensitive  and  the 
horny  laminae,  leading  finally  to  their  complete  separation 
at  the  region  of  the  toe.  Fig.  116  illustrates  this  state  of 
affairs  after  laminitis  has  existed  for  a  week.  The  sensi- 
tive and  horny  laminae  are  here  shown  to  be  distinctly 
separated  from  each  other,  a  well-marked  cavity  existing 
between  them,  which  cavity  is  greatest  in  extent  at  the  toe 


Mi 

r 

1/v 

4 

/ 

w 

^v— 

~  -^u. 

My 

Fig.    116. — Longitudinal   Section   of  a   Foot   with   Laminitis 
of  Eight   Days'   Standing. 
The    separation  between   the    sensitive   structures   and  the   hoof 
is  indicated  by  a  dark  line.     The  cavity  is  filled  with  exu- 
date.    It  will  be  noted  that  as  yet  there  is  little  change  in 
the   position   of  the   os   pedis. 

of  the  os  pedis.  With  the  sensitive  structures  thus  de- 
tached from  the  wall,  it  is  evident  that  very  much  that 
formerly  held  the  os  pedis  in  normal  position  has  been 
destroyed.  What  then  happens  is  that  the  whole  of  the 
body-weight  is  placed  upon  the  sole.  Never  intended  to 
bear  the  strain  thus  imposed,  it  naturally  sinks.  With 
the  sinking  is  a  corresponding  '  dropping '  of  the  pedal 
bone — in  fact,  of  the  whole  of  the  body  column.  Seeing 
that  the  structures  above  the  hoof  are  still  normally 
adherent  to  the  bones,  it  follows  that  they  must,  as  the  os 


266         DISEASES  OF  THE  HORSE'S  FOOT 


pedis  sinks,  be  carried  with  it.  As  a  consequence  we  get  a 
marked  depression  at  the  coronet  (see  Fig.  117,  a),  which 
depression  may  be  often  noticed  after  the  second  or  third 
week  of  a  severe  attack  of  the  disease. 

Here,  again,  though  to  a  greater  extent  than  that  caused 
by  the  haemorrhage  alone,  the  os  pedis  appears  to  be  pushed 
backwards,  the  space  at  the  toe  between  the  bone  and  the 
horny  box  being  closely  filled  with  the  yellow,  slightly 
blood-stained  exudate.     This  condition  is  well  depicted  in 


Fig.  11/. 


Fig.    117. 


■Longitudinal  Section   of   a  Foot   with  Laminitis 
of   Fourteen   Days'   Standing. 


a,  The  depression  at  the  coronet  caused  by  the  dropping  of  the 
bony  column  within  the  horny-box;  bf  a  portion  of  the 
sensitive  sole  pushed  downwards  and  forwards  by  the  de- 
scending  os   pedis. 

With  the  descent  of  the  os  pedis  we  get  in  many  cases 
a  penetration  of  the  horny  sole  (see  Fig.  117),  leading 
always  to  serious  displacement  of  the  sensitive  sole  (see 
Fig.  117,  b),  and  often  to  caries  of  the  exposed  bone. 

The  backward  displacement  of  the  os  pedis  may  be 
accounted  for  in  two  ways.  Firstly,  the  greater  vascularity 
of  the  membrane  covering  its  front  leads  to  a  greater  out- 
pouring of  inflammatory  fluid  in  that  particular  position. 
Flere,  therefore,  loss  of  adhesion  with  the  wall  is  greatest, 
while  into  the  cavity  so  formed  is  poured  a  large  quantity 


DISEASES  OF  THE  HORSE'S  FOOT         267 

of  a  fluid  that  is  practically  incompressible.  The  os  pedis 
must  be  pushed  backwards.  Secondly,  the  manner  in  which 
the  animal  distributes  his  weight — namely,  upon  the  heels 
— is  calculated  to  aid  in  the  bone's  backward  movement, 
for  with  his  feet  in  this  position  tension  under  the  extensor 
pedis  is  relaxed,  while  that  upon  the  flexor  perforans  is 
greatly  increased. 

(c)  Suppuration. — Should  the  animal  survive  the  pain 
and  exhausting  calls  made  upon  his  system  by  the  accom- 
panying fever  of  the  foregoing  conditions,  the  case  ends 
either  in  resolution  or  suppuration.  When  suppuration 
occurs  it  is  found,  as  a  rule,  at  the  sole,  leading  to  almost 
entire  separation  of  the  sensitive  and  horny  structures. 
The  pain,  if  possible,  is  even  worse  than  in  either  of  the 
foregoing  stages,  and  relief  for  the  suffering  patient  is  only 
obtainable  by  the  natural  exit  of  the  pus  at  the  coronet,  or 
by  giving  it  escape  with  the  knife  at  the  sole.  As  a  rule, 
suppuration  in  laminitis  is  rare,  and  then  only  occurs  when 
the  disease  has  been  of  some  several  days'  duration.  It 
has  been  the  author's  experience,  however,  to  meet  with  it 
in  a  case  but  three  days'  old.  This  particular  animal  had 
laminitis  restricted  to  the  hind-feet.  The  condition  was 
diagnosed  and  pus  liberated  at  the  sole  of  one  foot  during 
the  third  day  of  the  lameness.  The  animal  was  cast  on 
the  fourth  day,  and  pus  obtained  from  the  sole  of  the 
opposite  foot. 

Complications. — In  a  moderate  case,  carefully  treated, 
laminitis  terminates  at  the  end  of  three  or  four  days  in 
resolution.  The  general  symptoms  of  fever  gradually  sub- 
side, the  appetite  returns,  and  the  walk  becomes  easier. 
Cases  thus  terminating  fortunately  leave  behind  them  no 
change  of  serious  importance,  either  in  the  sensitive  tissues 
or  in  the  horny  envelope.  Should  resolution,  however,  be 
longer  delayed,  then  the  case,  although  eventually  termi- 
nating successfully  so  far  as  soundness  in  gait  is  concerned, 
leaves  more  or  less  evidence  behind  in  the  shape  of  rings 
about  the  wall  and  alterations  in  the  build  of  the  sole. 

When  the  happy  ending  of  rapid  resolution  is  denied  us, 


268        DISEASES  OF  THE  HORSE'S  FOOT 

then,  in  addition  to  the  condition  we  have  described  as 
suppuration,  we  may  meet  with  one  or  other  of  the  follow- 
ing complications : 

(a)  Metastic  Pneumonia. — This  complication  is  not  un- 
common, and,  when  occurring,  more  often  than  not  ends 
fatally.  It  may  be  accounted  for  indirectly  by  the  greater 
work  the  lungs  are  called  upon  to  perform  in  carrying  out 
the  increased  number  of  respirations  occasioned  by  the 
general  fever  and  pain,  and  directly  by  the  poisonous 
materials  circulating  in  the  blood-stream. 

(b)  metastatic  Colic. — This  may  be  either  a  subacute 
obstruction  of  the  bowel  or  an  enteritis  accompanied  by  an 
offensive  purge. 

A  striking  case  of  the  former  is  related  in  the  Veterinary 
Journal  (vol.  xvi.,  p.  180)  by  H.  Thompson,  of  Aspatria. 
Here  no  evacuation  of  the  bowels  occurred  for  three  days, 
and  the  pains  of  laminitis  were  added  to  by  the  usual  pains 
ct  intestinal  obstruction. 

The  colic  of  enteritis  is  in  some  cases  caused  by  the 
nature  of  the  food,  giving  rise  to  laminitis.  In  our  opinion, 
however,  it  is  more  often  occasioned  by  the  drastic  action 
of  the  aloes  nearly  always  resorted  to  in  the  treatment  of 
the  disorder.  As  does  the  pneumonia,  the  enteritis  thus 
brought  about  nearly  always  Has  a  fatal  termination. 

(c)  Gangrene  of  the  Structures  within  the  Hoof. — This 
complication  is  the  one  most  to  be  dreaded.  It  occurs  as  a 
result  of  the  great  pressure  exerted  by  an  excessive  exuda- 
tion, and  doubtless  affects  first  the  laminae  and  softer 
structures.  Once  commenced,  however,  it  rapidly  extends 
to  death  of  the  other  structures  (ligament,  tendon,  and 
even  bone),  and  gives  a  fatal  ending  to  the  case. 

The  gangrene  of  the  tissues  ("  mortification  "  as  our 
older  writers  called  it)  has  occurred  is  soon  made  evident 
to  the  veterinarian  by  the  symptoms  shown  by  the  patient. 
1  he  agonizingly  acute  pains  suddenly  subside,  the  feet  are 
placed  firmly  and  squarely  to  the  ground,  and  the  animal 
walks  with  ease.  Perhaps  but  the  night  before  the  patient 
is  seen  racked  with  excruciating  pain ;  the  morning  sees 


INFLAMMATORY  AFFECTIONS  269 

the  astounding  change  of  apparent  absolute  recovery.  Too 
well,  however,  the  eye  of  the  experienced  veterinary  surgeon 
sees  that  such  is  not  the  case.  Even  before  proceeding  to 
take  a  record  of  the  other  symptoms,  he  knows  that  it  is 
but  the  commencement  of  the  end.  Methodically,  however, 
he  notes  the  other  conditions.  The  pulse  he  finds  small 
and  imperceptible,  save  at  the  radial.  The  thermometer 
registers  a  subnormal  temperature,  the  extremities  are 
cold,  and  cold  sweats  bedew  the  body.  To  the  same  ex- 
perienced eye  the  countenance  of  the  animal  is  almost  sug- 
gestive of  what  has  occurred.  The  drawn  and  haggard 
expression,  to  which  we  have  previously  referred,  becomes 
more  marked,  and  the  angles  of  the  lips  are  drawn  back 
in  what  has  been  described  by  some  writers  as  a  '  sardonic  ' 
grin. 

We  can  best  express  what  the  whole  look  of  the  animal's 
countenance  indicates  to  us  by  saying  that  it  gives  us  the 
impression  that  the  animal  himself  knows  that  some  serious 
change,  and  a  change  fatally  inimical  to  his  chances  of  life. 
has  taken  place  in  his  feet. 

It  may  be  that  in  some  odd  cases,  although  it  has  not 
yet  been  our  lot  to  meet  with  them,  gangrene  may  terminate 
in  the  casting  off  of  one  or  more  hoofs.  Needless  to  say, 
there  can  still  be  but  one  termination  to  the  case. 

(d) Periostitis  and  Ostitis. — This  complication  is  referred 
to  by  other  writers  under  the  term  of  '  Peditis.'  It  signifies, 
of  course,  that  the  periosteum  and  the  bone  have  become 
invaded  by  the  inflammatory  process.  It  is  our  opinion 
that  these  two  conditions,  even' including  an  actual  arthritis, 
always  exist,  even  in  an  attack  of  laminitis  that  ends 
favourably.  "\Ye  do  not  claim,  however,  to  be  able  to  relate 
any  means,  save  that  of  post-mortem  examination,  by 
which  it  may  be  singled  out  from  the  other  changes  occur- 
ring in  the  foot.  The  high  fever  and  pain  occasioned  by 
the  inroads  of  the  inflammation  into  the  other  sensitive 
structures  serves  to  effectually  mask  whatever  evidence  of 
it  we  might  otherwise  obtain.  It  may  be  sometimes  only 
small  in  degree,  but  we  feel  confident  that  inflammation,  at 


270 


DISEASES  OF  THE  HORSE'S  FOOT 


any  rate  of  the  outer  layer  of  the  periosteum,  is  in  laminitis 
constant  even,  we  repeat,  in  a  mild  case. 

When  the  case  is  a  serious  one  we  have  ample  evidence 


p 

M. 

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— — 

Fig.  118. — Showing  Changes  in  the  Os  Pedis  with  Laminitis  of 
Standing,     (a,  Viewed   from  the  front;  b,  viewed 
from   the    side.) 
The   porous   condition   of   the  bone,  which  is  here   shown,  is  a 
result    of    rarefying    or    rarefactive    ostitis.      This    specimen 
also    illustrated    (what    the    photograph    cannot    show)    an 
accompanying  condition  of  condensation  of  bone,  or  osteo- 
plastic   ostitis.      (For    a    fuller    description    of    the    changes 
occurring  in  these  forms  of  ostitis;  see  Chapter  XL) 

to  show  that  ostitis  exists,  and  exists  in  a  severe  form. 
The  bones  become  vastly  altered  in  shape,  a  process  of 
absorption  leads  to  the  formation  of  large,  irregular  cavities 
within   their   substance,   and   what  of   the  bone  is   left   is 


INFLAMMATORY  AFFECTIONS  271 

rendered  hard  and  ivory-like  (condensed)  near  what  was 
the  original  centre,  while  the  edges  and  other  portions  show 
often  a  tendency  to  become  brittle  and  porous. 

Fig.  118  illustrates  the  effects  of  a  severe  ostitis  in  pedal 
bones  removed  from  hoofs  with  laminitis  of  several  weeks' 
standing. 

(e)  Chronic  Laminitis. — The  most  common  complication 
— or,  perhaps,  rather  we  should  term  it  '  sequel  ' — to  acute 
laminitis  is  the  chronic  form  of  the  disease.  For  this  con- 
dition we  have  reserved  a  separate  section  of  our  work.  It 
will  be  found  described  in  Section  B  1  of  this  chapter. 

Diagnosis  and  Prognosis. — One  is  almost  tempted  to  state 
that  the  diagnosis  of  laminitis  offers  no  difficulty.  In  the 
very  early  stages,  however,  it  may,  as  we  have  already 
indicated,  be  mistaken  for  the  oncoming  of  Enteritis, 
Lymphangitis,  or  even  Pneumonia.  The  paddling  of  the 
feet  may  help  us.  If  this  is  absent,  however,  nothing  but 
a  most  careful  examination,  or,  if  necessary,  the  withhold- 
ing of  our  opinion  until  the  following  visit  will  prevent  a 
blunder  being  made. 

Even  when  well  established,  laminitis  has  been  mistaken 
for  paralysis,  for  tetanus,  for  rheumatic  affections  of  the 
loins,  or  even  for  some  undiscovered  affection  of  the  muscles 
of  the  arms  and  chest.  This  latter  is  no  doubt  suggested 
to  the  uninitiated  by  the  reluctance  the  animal  shows  to 
move  the  muscles  apparently  of  that  region,  and  led  the 
older  writers  to  give  to  the  disease  its  name  of  '  Chest- 
founder."  It  is  only  fair  to  add,  however,  that  these 
blunders  in  diagnosis  are  nearly  always  committed  by  per- 
sons without  a  veterinary  training. 

Thus  wTarned,  the  veterinary  surgeon  of  average  ability 
should  have  no  difficulty  in  establishing  a  distinction  be- 
tween the  diseases  we  have  enumerated  as  likely  to  be 
confounded  wTith  it,  and  the  one  this  chapter  is  describing. 

The  prognosis  in  liminitis  should,  in  our  opinion,  always 
be  guarded.  Xo  advice  given  in  a  work  of  this  description 
can  be  of  any  real  use,  for  every  case  must  be  judged 
entirely  on  its  merits.     The  severity  of  the  symptoms,  the 


272         DISEASES  OF  THE  HORSE'S  FOOT 

cause  of  the  attack,  the  complications,  and  the  idiosyncrasies 
of  the  patient,  have  all  to  be  taken  into  account.  These  the 
veterinarian  must  be  left  to  judge  for  himself. 

Treatment. — The  treatment  of  acute  laminitis  in  its 
early  stage  must  be  based  upon  the  fact  that  we  have  to 
deal  with  a  congested  state  of  the  circulatory  apparatus 
of  the  whole  of  the  keratogenous  membrane.  This  fact 
was  well  enough  known  to  the  older  veterinarians.  It  is 
not  surprising,  therefore,  to  learn  that  jugular  phlebotomy 
was  at  once  resorted  to  as  the  readiest  means  of  relieving 
the  overcharged  vessels  of  their  blood.  As  a  matter  of 
fact,  bleeding  from  the  jugular  is  still  advocated  by  modern 
authorities.  We  cannot  say,  however,  that  we  unhesi- 
tatingly recommend  it.  Mechanically,  of  course,  the 
removal  of  a  large  quantity  of  blood  is  bound  to  result 
in  a  lowering  of  the  pressure  in  the  vessels.  The  effect, 
however,  is  but  transient.  Blood  removed  in  this  way  is 
again  quickly  returned  to  the  vessels  so  far  as  its  fluid 
matter  is  concerned,  and  the  pressure,  removed  for  a  time, 
is  again  as  great  as  before.  With  the  other  and  more  vital 
constituents  of  the  blood-stream — namely,  the  corpuscles — 
restoration  is  not  so  rapid.  We  have,  in  fact,  a  weakened 
state  of  the  system,  in  which  it  is  probable  it  will  not  so 
successfully  combat  the  adverse  conditions  the  desease  may 
induce. 

With  these  prefatory  remarks,  wre  may  advise  bleeding 
under  certain  conditions.  The  quantity  removed  must  be 
moderate  (7  to  8  pints),  and  the  pulse  and  other  condi- 
tions must  show  no  signs  of  weakness  or  collapse. 

Local  bleeding,  either  from  the  toe  or  the  coronet,  is  also 
advised.  In  the  former  situation  the  sole  is  thinned  down 
until  a  sufficient  flow  is  obtained,  while  at  the  coronet 
scarification  is  the  method  adopted.  Bleeding  locally, 
however,  is  far  less  effectual  than  the  jugular  operation. 
Neither  must  it  be  forgotten  that  wounds  in  these  situa- 
tions, more  particularly  at  the  toe,  are  extremely  liable, 
especially  with  the  existing  poisoned  state  of  the  blood- 
current,  to  take  on  a  septic  character.   What  might  possibly 


INFLAMMATORY  AFFECTIONS  273 

have  remained  a  comparatively  simple  inflammation  is  in- 
duced by  the  operation  itself  to  terminate  in  the  more  com- 
plicated and  serious  condition  of  suppuration. 

Other  means  of  combating  the  congested  state  of  the 
membrane  are  principally  those  of  local  applications. 
V\  itli  many  veterinary  surgeons  warm  poulticing  is  still 
largely  advocated  and  practised.  We  do  not  believe  in  it. 
Warmth,  as  a  means  of  removing  local  congestion,  can  only 
be  successful  when  applied  widely  round  the  congested  area, 
and  so  dilating  surrounding  bloodvessels  and  lymphatics. 
Applied  to  the  congested  area  itself,  and  to  that  alone,  it  is 
almost  worse  than  useless. 

With  the  foot,  both  around  and  below  it,  surrounding 
area  is  denied  us.  The  only  vessels  we  are  able  to  dilate 
with  the  warmth,  and  so  enable  them  to  carry  off  the  fluid 
from  the  congested  foot,  are  those  in  the  limb  above.  That 
poulticing  cannot  be  successfully  there  applied  is  self- 
evident.  Apart  from  that,  it  is  an  open  question  whether 
poultices  may  not  do  actual  harm  in  inducing  suppuration 
in  cases  where,  probably,  it  would  not  otherwise  occur. 

For  these  reasons  we  hold  to  the  opinion  that  when  a 
local  application  is  determined  on  it  should  be  a  cold  one. 
Various  methods  of  applying  cold  are  in  vogue.  Cold  swabs 
are  perhaps  most  in  favour.  They  must,  however,  be  kept 
cold.  When  a  suitable  water-course,  pond,  or  other  expanse 
of  shallow  water  is  at  hand,  then  the  animal  may  be  kept 
standing  therein,  or  preferably  walked  about  in  it.  When 
suitable  apparatus  is  obtainable,  a  constant  stream  over  each 
foot  from  a  rubber  hosepipe  is  most  beneficial. 

Astringent  baths,  containing  solutions  of  alum,  of  copper 
sulphate,  of  iron  sulphate,  or  of  common  salt,  or  composed 
of  a  mixture  of  two  or  more  of  the  salts  mentioned,  may 
also  be  used  with  advantage.  In  addition  to  the  fact  that 
such  solutions  are  for  a  time  below  the  temperature  of 
simple  water,  we  have  the  advantage  that  they  have  also  a 
more  or  less  antiseptic  property. 

While  on  the  subject  of  the  relief  of  the  congestion,  we 
must  not  forget  to  mention  a  treatment  which  we  ourselves 


274 


DISEASES  OF  THE  HORSE'S  FOOT 


have  practised  with  considerable  success — namely,  that  of 
forced  exercise.  It  appears  to  have  been  first  brought  into 
prominence  by  Mr.  Broad,  of  Bath,  and  the  two  terms 
'  Forced  Exercise  and  Rocker  Shoes  '  and  '  Broad's  Treat- 
ment' have  come  to  be  synonymous. 

The  Broad  shoe  is  a  shoe  with  a  web  of  quite  twice  the 
thickness  of  the  animal's  ordinary  shoe,  and  has  this  web 
gradually  thinned  from  the  toe  backwards  until  at  the  heels 
the  shoe  is  at  its  thinnest  (see  Fig.  119). 

The  excessive  thickness  of  the  shoe  serves  two  purposes. 
It  allows  of  the  requisite  amount  of  slope  being  given  to  the 
v/eb,  and  so  enables  the  animal  readily  to  throw  himself 
back  on  to  his  heels,  a  position  in  which,  as  we  have  already 


Fig.    119.— Seated   Rocker   Bar  Shoe    (Broad's)    for  Treatment 
of  Laminitis. 

indicated,  he  obtains  the  greatest  ease.  It  also  minimizes 
to  some  extent  the  effects  of  concussion. 

With  forced  exercise,  as  practised  by  Mr.  Broad,  this 
shoe  is  first  applied,  and  the  animal  afterwards  made  to 
walk  upon  soft  ground,  or  even  upon  the  roadway,  for  a 
half  an  hour  to  an  hour  and  a  half  three  times  a  day. 

For  our  own  part,  we  consider  the  shoe  to  be  almost  if 
not  quite  superfluous,  so  far  as  its  influence  upon  the 
progress  of  the  disease  is  concerned.  We  therefore  dis- 
pense with  it,  and  have  the  animal  exercised  in  his  ordinary 
shoes.  To  do  this,  the  patient  has  sometimes  to  be  severely 
flogged  into  taking  the  first  few  steps.  After  that  progress 
gradually  becomes  easier. 

It  has  been  said  to  be  cruel.  In  so  far  as  we  knowingly, 
and  of  set  purpose,  occasion  the    animal    pain,    cruel    it 


INFLAMMATORY  AFFECTIONS  275 

undoubtedly  is ;  but  it  is  cruelty  with  an  aim  that  is  truly 
benevolent,  and  the  object  of  our  benevolence  is  the  animal 
upon  whom  the  cruelty  is  practised. 

One  word  of  advice  is  needed.  The  forced  exercise  must 
be  commenced  early.  In  the  later  stages,  when  the  stage 
cf  congestion  has  passed  from  that  to  the  acuter  stages  of 
the  inflammation  and  the  outpouring  of  the  inflammatory 
exudate,  then  forced  exercise  cannot  be  safely  commenced. 
The  loss  of  adhesion  between  the  pedal  bone  and  the  horny 
box,  which  we  know  to  be  then  existent,  negatives  its  advi- 
sability. 

By  many  it  is  advised  to  always  remove  the  shoes.  From 
what  we  have  already  said,  it  will  be  seen  that  this  is  not 
our  practice.  But  one  argument  in  favour  of  so  doing 
appears  to  us  to  carry  weight,  and  that  is  that  '  dropping  ' 
of  the  sole  is  probably  prevented  from  becoming  so  marked. 
That  condition,  however,  is  entirely  dependent  upon  the 
changes  occurring  within  the  horny  box.  It  is  bound  to 
occur  with  the  animal  shod  or  unshod,  and  to  reach  a  stage 
when  only  contact  with  the  ground  prevents  its  further 
descent.  The  complication  then  sometimes  following — 
namely,  penetration  of  the  sole  by  the  bone,  is  not  prevented 
by  having  the  shoes  removed.  It  may,  in  fact,  be  thus 
rendered  more  likely. 

Internal  treatment  consists  in  the  exhibition  of  suitable 
febrifuges  and  the  administration  of  a  dose  of  aloes. 

With  regard  to  the  wisdom  of  the  latter  proceeding, 
opinion  seems  to  be  divided.  Personally,  we  hold  an  open 
mind  concerning  it.  This  much  is  certain :  in  many  cases 
of  laminitis — those  cases  which  have  their  origin  in  over- 
feeding with  an  irritating  food — there  is  already  a  strong 
predisposition  to  enteritis.  The  administration  of  aloes  in 
this  case  is  extremely  apt  to  induce  a  fatal  superpurgation. 
Aloes  is,  again,  contra-indicated  when  the  laminitis  is  a 
result  of  excessively  long  journeys,  and  the  patient  is 
already  greatly  exhausted.  Neither  can  it  be  advocated  in 
the  laminitis  occurring  as  a  sequel  to  septic  metritis  or  to 
pneumonia. 


2/6        DISEASES  OF  THE  HORSE'S  FOOT 

On  the  other  hand,  when  the  disease  has  occurred  as  a 
result  of  long  standing  in  the  stable  and  an  overloaded 
condition  of  the  bowels,  or  where  one  full  meal  of  some 
constipating  food,  such  as  whole  wheat,  pea  or  bean  meal, 
wheat  or  barley  meal,  has  occasioned  the  attack,  then  a 
dose  of  aloes  at  the  commencement  of  the  treatment  is 
productive  of  good. 

Suitable  febrifuges  are  found  in  potassium  nitrate, 
potassium  chlorate,  sodium  sulphate,  or  magnesium  sul- 
phate, either  of  which  or  a  mixture  of  two  or  more  of  them, 
the  animal  will  readily  take  in  his  drinking-water. 

The  administration  of  sedatives  is  also  indicated.  In 
this  connection  aconite  will  be  found  most  useful.  More 
especially  in  the  early  stages  of  the  disease,  when  pain  is 
excessive  and  the  temperature  high,  will  its  good  effects  be 
noticed.  This  also  the  animal  will  often  take  in  his  drink- 
ing-water. iWe  have  been  in  the  habit  of  so  prescribing 
the  B.P.  tincture  in  ^-dram  doses  three  times  daily.  By 
its  use  the  temperature  is  rapidly  lowered,  the  pulse  re- 
duced in  number  and  in  fulness,  and  the  pain  in  some  in- 
stances perceptibly  diminished.  With  others  hypodermic 
injections  of  morphine  and  atropine  have  given  equally 
satisfactory  results. 

Needless  to  say,  good  nursing  is  a  sine  qua  non.  During 
the  first  stages  of  the  fever  a  light  and  easily  digested  diet 
should  be  allowed  —  bran-mashes,  roots  and  grass  when 
obtainable,  and  a  carefully  regulated  supply  of  water. 
The  animal  should  be  warmly  clothed  and  the  box  well 
ventilated,  even  to  the  opening  of  the  doors  and  windows. 
Only  in  this  way  is  pneumonia  as  a  sequel  sometimes  pre- 
vented. The  patient's  comfort  should  be  attended  to  in 
providing  him  with  a  suitable  bed.  Anything  in  the  shape 
of  long  litter  should  be  avoided.  When  nothing  else  is  at 
hand,  litter  that  has  already  been  broken  and  shortened 
by  previous  use  is  best.  With  this  the  box  floor  should  be 
thickly  covered,  and  matting  of  the  material  prevented  by 
constant  turning.  A  good  bed  for  the  horse  with  laminitis 
is  peat-moss  mixed  with  short  straw.     This,  without  being 


INFLAMMATORY  AFFECTIONS  277 

dragged  into  irregular  heaps,  remains  springy  and  elastic 
with  but  little  attention.  Better  than  all,  however,  espe- 
cially with  good  weather,  is  an  open  crewyard.  Here  the 
animal  has  an  abundance  of  fresh  air,  has  a  bed  that  is 
always  soft,  and  has  plenty  of  room  in  which  to  get  up  and 
down  with  some  degree  of  ease. 

Leaving  the  dietetic  and  medicinal,  we  may  consider 
other  treatments  of  laminitis  that  come  more  particularly 
under  the  heading  of  operative. 

The  first  matter  that  here  demands  our  attention  is  that 
oi  allowing  the  exudate  to  escape  at  the  sole.  If  after  the 
expiration  of  three  or  four  days  pain  and  other  symptoms 
of  distress  continue,  then  it  may  be  judged  that  the  in- 
flammatory exudate  has  made  its  appearance.  Operative 
measures  allowing  of  its  escape,  though  not  giving  absolute 
ease,  do  undoubtedly  relieve  the  more  marked  expressions 
of  suffering,  and  should  be  at  once  determined  on.  To  do 
this  completely  it  is  necessary  to  cast  the  animal.  The 
sole  is  then  thinned  at  the  toe  with  the  drawing-knife  until 
the  sensitive  structures  are  reached.  A  flow  of  yellow  and 
sometimes  blood-stained  discharge  is  immediately  obtained, 
and  the  sole  itself  found  to  be  underrun  to  a  consider- 
able extent.  An  opening  sufficiently  large  to  admit  of 
free  drainage  (about  the  size  of  a  half  a  crown-piece)  is 
made,  the  wounds  antiseptically  dressed,  and  the  hobbles 
removed. 

If  showing  an  inclination  to  do  so,  the  animal  should 
then  be  allowed  to  remain  and  rest.  In  one  instance  in 
which  we  so  operated  (a  case  of  laminitis  in  the  hind-feet 
alone),  the  relief  given  was  at  once  manifested.  For  three 
days  previously  the  animal  had  remained  standing  in 
agonizing  pain.  On  the  fourth  he  was  cast,  and  the  dis- 
charge— partly  inflammatory  exudate,  and  partly  a  sanious 
foetid  pus — liberated.  The  hobbles  were  removed,  and  the 
animal  allowed  to  remain  down  while  our  attention  was 
drawn  to  another  case.  This  attended  to,  we  walked 
back  to  the  field  where  our  first  patient  was  lying.  His 
breathing,  but  a  short  time  before  distressedly  short  and 


278        DISEASES  OF  THE  HORSE'S  FOOT 

catching,  was  now  so  slow  and  deeply  regular  that  for  one 
brief  moment  the  thought  flashed  across  our  mind  that  he 
was  dead.     He  was  in  a  profound  sleep. 

Other  operators  sometimes  give  the  exudate  escape  while 
making  the  grooves  in  what  is  now  known  as  '  Smith's 
Operation.' 

In  this  operation  the  hoof  is  so  grooved  as  to  allow  of 
its  expansion,  so  relieving  the  pressure  on  the  sensitive 
structures  within  it.  Incidentally,  the  inflammatory  exudate 
is  given  exit. 


Fig.    120. — Diagram  of   Hoof  showing  the  position   of  the 
Three  Grooves  made  in  the  Treatment  of  Laminitis. 


The  animal  is  cast,  the  shoes  removed,  and  three  vertical 
grooves  made  in  the  wall.  The  first  is  cut  down  the  centre 
of  toe,  extending  from  the  coronet  to  the  ground  surface. 
The  second  is  made  to  the  right  of  this,  and  the  third  to  the 
left,  each  following  2  inches  from  the  first  (see  1,  2,  and  3, 
Fig.  120). 

Each  of  the  grooves  must  run  completely  from  the 
coronary  margin  to  the  ground  surface,  and  each  should  be 
carried  through  the  substance  of  the  horn  until  the  horny 
laminae  are  reached.  This  done,  the  underneath  surface  of 
the  foot  is  grooved  at  the  white  line  (see  curved  groove  4, 


INFLAMMATORY  AFFECTIONS  279 

Fig.   121  )   in  such  a  manner  as  to  entirely  isolate  the  two 
pieces  of  horn  a  and  b  from  the  remainder  of  the  hoof. 

Expansion  of  the  horny  box  is  thus  brought  about,  while 
at  the  same  time  the  semicircular  groove  at  the  toe  is  made 
deep  enough  to  allow  of  the  escape  of  the  exudate. 

If  thought  wise  by  the  operator,  the  two  pieces  of  horn 
a  and  b  may  be  isolated,  and  the  exudate  given  exit  by 
making  the  fourth  groove  in  the  position  of  the  dotted 
lilies  in  Fig.  120 — that  is  to  say.  at  the  lowermost  portion 
of  the  sensitive  structures.  By  this  means  the  sole  will  be 
left  intact. 

1 
% 


Fig.   121. — Lower  Surface  of  Foot  showing  position  of  the 
Grooves  made  in  the  Treatment  of  Laminitis. 

Fuller  instruction  for  making  the  grooves  and  the  instru- 
ments required  will  be  found  described  in  Section  C  of 
Chapter  N. 

The  animal  should  be  afterwards  shod,  and  the  bearing 
oil  the  portions  a  and  b  of  the  wall  removed.  Almost 
immediate  relief  is  afforded  the  patient. 

Rcordcd  Cases. — 1.  '  On  the  evening  of  September  2S 
last,  I  was  called  rather  hurriedly  to  attend  a  posting-horse 
which  had  just  arrived  from  a  twenty-one  miles'  journey. 
and  was  said  to  be  "  very  ill."  I  lost  no  time  in  proceeding 
to  the  spot,  and  found  my  patient  '"very  ill"  indeed.     No 


280         DISEASES  OF  THE  HORSE'S  FOOT 

need  for  long  consideration  as  to  diagnosis ;  the  symptoms 
showed  at  once  that  I  had  an  uncommonly  severe  case 
of  acute  founder  before  me.  On  examination  I  found  the 
pulse  was  120,  the  respirations  100,  and  the  thermometer 
106°  F.  The  poor  brute  could  not  move,  the  fore-legs 
were  well  out  before,  and  the  hind-legs  thrown  back  be- 
hind ;  in  fact,  he  was,  as  one  might  say,  propping  himself 
up  with  his  four  legs ! 

'  On  examining  his  feet,  I  discovered  what  I  had  never 
cither  seen  or  heard  of  before — namely,  blood  freely  oozing 
out  at  the  coronet  of  all  four  feet;  if  anything,  the  hind- 
feet  were  the  worst,  and,  showing  that  this  bloody  discharge 
at  coronets  had  commenced  during  progression  and  before 
lit  was  stabled,  the  inside  of  the  thighs  were  all  shotted 
over  with  blood,  which  had  been  thrown  up  by  his  feet 
while  he  was  trotting  or  walking.  He  was  completely 
soaked  all  over  with  perspiration. 

'  My  prognosis  could  not  well  be  otherwise  than  unsatis- 
factory. I  resolved,  however,  to  do  all  I  could  to  relieve 
the  poor  suffering  brute.  As  a  matter  of  course,  jugular 
phlebotomy  was  utterly  impracticable ;  so,  to  relieve  the 
pressure  in  the  feet,  I  had  him  (after,  with  extreme  diffi- 
culty, removing  the  shoes)  bled,  or  rather  opened,  at  all 
four  toes,  and  hot  poultices  applied.  On  opening  the  off- 
side toe,  in  both  hind  and  fore  feet,  I  found  an  escape 
of  very  dark-coloured  blood,  with  a  great  many  bubbles 
oi  gas,  thus  showing  that  the  destructive  process  was  fairly 
established  in  the  two  bony  extremities  mentioned.  The 
near  fore  and  near  hind  feet  showed  no  signs  of  gas- 
bubbles  on  being  opened  at  the  toe. 

'  I  gave  a  laxative  in  combination  with  a  diffusible 
stimulant,  and  ordered  doses  of  aconite  and  potassium 
iodide ;  I  also  applied  strong  sinapisms  to  each  side, 
immediately  behind  the  shoulders.  After  three  hours  I 
found  my  patient  rather  easier;  respiration  about  90,  and 
temperature  104° ;  willing  to  take  a  little  water,  and  even 
attempted  to  take  some  hay.  Ordered  continued  applica- 
tions of  hot  water  to  the  poultices  at  feet,  and  clothed  him 


INFLAMMATORY  AFFECTIONS  281 

up  for  the  night.  Next  morning  there  was  little  improve- 
ment; respirations  over  80,  and  temperature  103 -5s.  Con- 
tinue same  treatment.  Second  morning,  horse  apparently 
easier;  temperature  102-5°,  but  very  difficult  respiration; 
laxative  had  operated  during  the  night ;  ordered  diffusible 
stimulants.  About  two  hours  and  a  half  after  my  last 
\isit,  the  horse  turned  round  in  his  stall  and  dropped  down 
dead ! 

'  History  of  the  Horse. — He  belonged  to  an  extensive 
horse-hiring  establishment ;  was  purchased  a  short  time 
before  for  £60 — a  long  price  for  a  post-horse — had  recently 
suffered  and  been  off  work  from  some  "  severe  cold  "  ;  was 
taken  out,  and  did  forty-seven  miles  of  a  journey  the  day 
before  I  saw  him;  on  forenoon  of  the  day  on  which  he  was 
attacked  he  did  two  or  three  short  turns,  and  then  twenty- 
one  miles  of  a  journey  in  the  afternoon,  during  which  he 
became  so  ill  as  scarcely  to  be  able  to  conclude  the  twenty- 
one  miles  ;  this  was  the  last  turn  he  was  to  do.  He  was  a 
grand  stepper,  and  no  doubt  was  pushed  a  little  during  this 
final  journey,  as  the  driver  intended,  after  a  short  rest,  to 
finish  off  with  the  twenty-six  miles  between  this  and  home. 
With  the  short  turn  on  the  second  forenoon,  this  would 
have  been  over  100  miles  in  less  than  two  days,  with  a 
horse  just  out  of  a  severe  cold!* 

2.  *  Whilst  attending  a  patient  on  a  farm  on  September  5 
last  my  attention  was  called  to  a  cart-horse,  five  years  of 
age,  that  had  been  castrated  in  the  standing  position  by  a 
traveling  castrator  about  ten  days  previously. 

'  I  found  the  animal  presenting  the  following  symptoms : 
Head  down,  blowing  hard,  very  dull,  and  disinclined  to 
move,  temperature  105°  F.,  hard,  rapid,  slightly  irregular 
pulse,  membranes  injected,  appetite  lost;  scrotum,  sheath, 
and  penis  tremendously  swollen,  castration  wounds  un- 
healthy, and  exuding  a  thin,  reddish-brown  discharge  of  a 
most  foetid  odour. 

'  The  next  day  well-marked  symptoms  of  laminitis  were 
present.     I  finally  ceased  attending  him  about  the  middle 

*  Veterinary  Journal,  vol.  xvii.,  p.  314  (A.  E.  Macgillivray), 


282        DISEASES  OF  THE  HORSE'S  FOOT 

of  October,  and  at  the  end  of  that  month  he  was  turned  out 
for  the  winter.'* 

3.  '  On  July  3  an  interesting  case  of  laminitis  came 
under  my  notice.  The  subject  was  a  mare,  eight  years  old, 
which  had  been  running  on  the  common  here  for  some 
months,  and  was  taken  up  on  the  night  of  July  2  by  a  boy, 
who  did  not  observe  anything  amiss  with  her.  The  follow- 
ing morning,  on  the  owner  going  to  the  stable,  he  found  the 
animal  in  great  pain,  and  at  once  sent  for  me.  I  discovered 
her  to  be  suffering  from  laminitis,  and  saw  her  again  in 
the  evening,  when  she  was  much  worse.  The  attack  proved 
to  be  a  most  severe  one. 

'  The  owner  informed  me  that  she  had  not  been  allowed 
any  corn  for  two  months,  and  that  she  had  no  distance  to 
travel  on  the  road  from  the  common. 

'  Though  on  such  a  poor  pasture,  the  mare  was  very  fat ; 
she  had  never  been  unwell  before  this  attack. 

'  This  is  the  first  case  I  have  seen  of  laminitis  occurring 
when  the  animal  was  on  grass.'  t 

B.   CHRONIC. 
1.     Chronic  Laminitis. 

Definition. — A  low  and  persisting  type  of  inflammation 
of  the  sensitive  structures  of  the  foot,  characterized  by 
changes  in  the  form  of  the  hoof,  and  incurable  pathological 
alterations  within  it. 

Causes. — Chronic  laminitis  more  often  than  not  is  a 
sequel  to  the  acute  form  we  have  just  described.  With  an 
attack  of  acute  laminitis  that  defies  treatment,  and  does  not 
end  in  resolution  in  from  ten  days  to  a  fortnight,  then  the 
chronic  form  may  be  expected. 

The  brittle  horn,  convex  sole,  and  other  changes  we  have 
described  under  Pumiced  Foot  may,  however,  be  regarded 
as    a    chronic    laminitis,    and    this    condition,    as    we    have 

*  Veterinary  Record,  vol.  xiv.,  p.  649   (Charles  A.   Powell). 
t  Veterinary  Journal,  vol.  ix.,  p.  176  (W.  Stanley  Carless). 


INFLAMMATORY  AFFECTIONS  283 

already  indicated  in  Chapter  VI.,  may  run  a  course  slow 
and  insidious  from  the  onset. 

Symptoms. — When  the  disease  arises  without  previous 
acute  symptoms,  the  first  thing  noticeable  is  an  alteration 
in  the  gait.  The  animal  begins  to  go  feelingly,  especially 
when  first  moved  out  from  the  stable.  Our  opinion  is  asked 
as  to  the  cause  of  the  lameness,  and  an  inspection  is  made. 
With  the  changes  in  the  form  of  the  hoof  as  yet  wanting, 
we  have  nothing  to  guide  us,  and  other  causes  for  the  lame- 
ness suggest  themselves,  probably  corns.  Evidence  of  these 
is  not  forthcoming,  and  we  in  all  probability  withhold 
our  opinion  until  a  later  visit.  On  the  second  or  a  sub- 
sequent call  we  are  perhaps  lucky  enough  to  find  our 
patient  down.  Diagnosis  is  then  rendered  easier.  Made 
to  rise,  the  animal  stands  in  the  attitude  we  have  described 
as  indicative  of  laminitis.  We  have  him  walked  and  trotted 
out.  The  symptoms  of  tenderness  disappear,  and  the 
animal  soon  goes  fairly  sound.  He  is,  in  fact,  workable — 
that  is,  by  anyone  who  is  careless  as  to  the  comfort  of  his 
beast. 

When  following  an  acute  attack,  we  have  the  most 
marked  symptoms  of  pain  and  distress,  somewhat  abating 
after  the  second  or  third  week.  The  walk,  however,  is  still 
painful,  and,  for  a  short  time  after  rising  from  the  ground, 
even  difficult. 

In  short,  in  both  cases  we  have  the  horse  going  on  his 
heels,  with  a  walk  that  is  painful,  and  with  symptoms  of 
pain  that  are  most  apparent  when  moved  on  after  a  rest. 

Later,  the  changes  in  the  form  of  the  hoof  begin  to 
appear.  It  seems  to  have  lost  its  elasticity,  and  is  seen  to 
be  dry  and  chippy,  and  to  have  become  denuded  of  its 
varnish-like  outer  covering. 

In  addition,  it  is  of  largely  altered  shape.  The  toe,  by 
reason  of  the  animal  walking  on  his  heels,  and  by  reason 
of  an  increased  growth  of  horn,  becomes  elevated,  so  that 
the  front  of  the  wall,  instead  of  forming  an  obtuse  angle 
with  the  ground,  comes  to  run  very  nearly  horizontal  with 
it.     The  horn  of  the  heels,  as  compared  with  that  of  the 


284         DISEASES  OF  THE  HORSE'S  FOOT 

toe,  takes  on  an  increased  growth.  The  same  thing  we 
have  already  indicated  as  happening  at  the  toe,  though  in 
lesser  degree.  Taken  together,  this  increased  growth  of 
horn  at  the  toe  and  at  the  heels  has  the  result  of  lengthen- 
ing the  diameter  of  the  foot  from  before  backwards,  the 
transverse  diameter  remaining  more  or  less  normal.  The 
hoof  thus  loses  its  circular  build,  and  comes  to  approach 
nearer  an  elongated  oval. 

At  this  stage,  too,  the  pathological  '  ribbing  '  of  the  hoof 
is  observable.  The  outer  surface  of  the  wall  becomes 
marked  wtih  a  series  of  ridges  encircling  the  hoof   from 


Fig.   122. — Foot  badly  deformed  as  a  Result  of  Chronic 
Laminitis. 

heel  to  feel  (see  Fig.  81,  which  illustrates  a  moderate  de- 
formity of  the  hoof  occurring  after  laminitis).  In  the 
badly  laminitic  hoof,  however,  this  deformity  is  largely 
increased,  until  in  some  cases  the  shapeless  mass  can  hardly 
be  likened  to  a  foot  at  all  (see  Fig.  122). 

The  inferior  or  solar  surface  of  the  foot  also  offers  cer- 
tain changes  for  our  consideration.  The  first  thing  that 
strikes  one  is  the  convexity  of  the  sole.  This,  as  we  have 
already  pointed  out,  is  due  to  descent  of  the  os  pedis,  and 
the  highest  point  of  the  convex  portion  is  that  immediately 
in  front  of  the  apex  of  the  frog.  Here  the  horn  is  some- 
times found  to  be  quite  yielding  to  the  finger,  is  excessively 


INFLAMMATORY  AFFECTIONS  2£5 

thin,  and  is  more  or  less  granular  and  inclined  to  break  up 
under  manipulation.  As  a  consequence,  any  rough  use  of 
the  drawing-knife,  or  an  accidental  wounding  with  sharp 
flints  or  stones,  leads  to  exposure  of  the  sensitive  struc- 
tures and  local  gangrene. 

With  the  horn  of  the  sole  thus  deteriorated  by  reason  of 
excessive  and  continued  pressure  upon  the  parts  secreting 
it,  it  is  not  surprising  to  find  that,  in  many  cases,  actual 
penetration  of  it  with  the  os  pedis  occurs.  It  is  the  anterior 
portion  of  the  inferior  margin  of  the  bone  that  makes  its 


Fig.  123. — Solar  Aspect  of  Foot  with  Chronic  Laminitis,  show- 
ing its  Abnormal  Oval  Shape  from  Before  Backwards,  and 
the  Excess  of  Horn  growing  from  the  White  Line  in  the 
Region  of  the  Toe. 

appearance,  and  shows  itself  as  a  small  semicircular  white 
or  dark  gray  line  on  the  sole. 

Exposure  of  the  bone  is  soon  followed  by  its  necrosis,  in 
which  case  the  wound  takes  on  an  ulcerating  character. 
From  it  there  is  a  discharge  of  pus,  black  in  colour  and 
offensive  in  smell,  and,  protruding  from  the  opening,  are 
excessive  granulations  of  the  remains  of  the  sensitive  sole. 

The  '  white  line,'  so  apparent  when  a  normal  foot  is 
cleansed  with  the  knife,  can  no  longer  be  sharply  distin- 
guished from  the  surrounding  horn,  while  in  some  cases  the 


2$6         DISEASES  OF  THE  HORSE'S  FOOT 

horn  composing  it  takes  on  an  abnormal  growth  at  the  toe 
(see  Fig.  123).  This  adds  still  further  to  the  abnormal 
lengthening  of  the  antero-posterior  diameter  of  the  foot 
already  mentioned. 

In  other  cases  horn  in  this  position  is  altogether  wanting, 
and  in  its  place  is  a  well-defined  cavity,  into  which  the 
blade  of  a  knife  can  be  readily  passed.  This  cavity  is 
bounded  in  front  by  the  original  wall  of  the  hoof,  and  is 
here  lined  by  a  degenerated  and  hypertrophied  growth  of 


Fig.   124.— ^Longitudinal  Section  of  a  Foot  with  Laminitis  of 
Three  Weeks'  Standing. 

On  the  anterior  face  of  the  cavity,  in  front  of  the  os  pedis,  are 
thickened  horny  laminae.  Due  to  the  sinking  of  the  bony  col- 
umn the  os  pedis  has  perforated  the  horny  sole. 

the  horny  laminae.  Posteriorly  the  cavity  is  bounded  by 
the  front  of  the  os  pedis,  and  is  lined  by  a  thin  growth  of 
horn  secreted  by  the  keratogenous  membrane  covering  the 
bone.  Superiorly  the  cavity  is  quite  narrow,  and  extends 
to  near  the  lower  surface  of  the  coronary  cushion,  while 
inferiorly,  at  its  open  portion,  it  is  often  J  inch  to  1  inch 
wide.  Laterally  it  extends  on  each  side  of  the  toe  to  the 
commencement  of  the  quarters. 

Exploration   with  a   director,   or  with   the    blade    of    a 


INFLAMMATORY  AFFECTIONS  287 

scalpel,  removes  from  the  opening  a  dry  detritus.  This 
is  composed  of  the  solid  constituents  of  the  escaped  blood, 
the  dried  remains  of  the  inflammatory  exudate,  and  broken- 
down  fragments  of  cheesy-looking  horn.  The  size  to  which 
the  cavity  may  sometimes  extend  is  illustrated  in  Fig.  124. 
The  thickened  horny  laminae  forming  the  anterior  boundary 
of  the  cavity  are  here  depicted,  together  with  commencing 
perforation  of  the  horny  sole  by  the  os  pedis.  It  is  this 
cavity  which,  when  opened  at  the  bottom  and  discharging 
its  mealy-looking  contents,  is  known  as  seedy-toe,  for  a 
further  description  of  which  see  p.  293. 

The  lameness  occurring  with  chronic  laminitis  does  not 
always  persist.  As  time  goes  on  the  sensitive  structures 
accommodate  themselves  to  the  altered  form  and  con- 
ditions of  the  horny  box.  In  certain  situations — namely, 
where  pressure  is  greatest — the  softer  structures  become 
atrophied,  and  sometimes  even  wholly  destroyed ;  while  in 
other  positions  the  changes  in  form  of  the  hoof  tend  to 
increase  in  size  of  its  interior,  with  a  consequent  diminu- 
tion of  pressure  upon,  and  increased  growth  of  the  struc- 
tures within  it. 

Pathological  Anatomy. — In  detailing  the  changes  to  be 
observed  in  chronic  laminitis,  we  take  up  the  description 
where  we  left  it  when  dealing  with  the  pathological  anatomy 
of  the  acute  form.  The  alterations  to  be  met  with  are  best 
observed  by  taking  a  foot  so  diseased  and  making  of  it  two 
sections — one  longitudinal,  from  before  backwards;  the 
other  horizontal,  and  in  such  a  position  as  to  cut  the  os 
pedis  through  at  its  centre. 

These  sections  will  expose  to  view  the  cavity  formed  by 
the  pouring  out  of  the  exudate,  and  its  full  extent  may  be 
noticed  by  examining  the  sections  alternately.  Taking  the 
horizontal  section  first,  it  will  be  seen  that  the  hollow  space 
extends  wholly  round  the  toe,  and  as  far  back  as  the  com- 
mencement of  the  quarters.  In  the  latter  position  one  is 
able  to  observe  laminae  still  in  their  normal  positions  and 
condition.  At  the  toe,  however,  the  horny  and  secretive 
laminae  are  widely  separated,  and  the  space  between  them 


288 


DISEASES  OF  THE  HORSE'S  FOOT 


filled  with  a  yellow,  semi-solid  material,  the  remains  of  the 
inflammatory  exudate  and  new  horn  secreted  by  the  kerato- 
genous  membrane.  The  laminae,  both  horny  and  sensitive, 
are  greatly  enlarged.  This  is  a  hypertrophy,  resulting  from 
the  continued  effects  of  the  inflammation,  and  leads  in  time 
to  the  formation  of  laminae  quite  three  or  four  times  their 
normal  size  It  is  this  hypertrophy  of  the  laminae  and 
the  pressure  of  the  exudate  that  causes  the  bulging  and 
increased  growth  of  the  horn  at  the  toe  (see  Fi.g  125),  and 


Fig.  125. — Longitudinal  Section  of  a  Foot  with  Laminitis  of 
Several  Years'  Duration. 


contributes  towards  the  oval  formation  of  the  foot  we  have 
mentioned  before. 

In  the  longitudinal  section  the  first  thing  noticeable  is 
the  change  in  position  of  the  bones,  more  especially  in  that 
of  the  os  pedis.  The  circumstances  we  have  mentioned 
before — pressure  of  the  exudate  upon  it  in  front  and  tension 
of  the  perforans  on  it  behind — have  caused  it  to  assume  a 
more  upright  position  than  is  normal,  so  much  so  that  in  a 
bad  case  the  front  of  the  bone  becomes  quite  vertical.  This 
vicious  direction  the  other  bones  of  the  digit  follow  (see 
Fig.  125). 


INFLAMMATORY   AFFECTIONS  289 

Consequent  upon  the  displacement  of  the  bone,  the 
plantar  cushion,  by  reason  of  the  continued  pressure  thus 
put  upon  it,  becomes  atrophied,  while  its  hinder  half  is,  as 
it  were,  squeezed  into  taking  up  a  position  more  posterior 
and  higher  in  the  digit  than  normally  it  should.  The  horn- 
secreting  papillae  covering  its  inferior  face  thus  become 
directed  backwards  sooner  than  downwards,  in  wThich  way 
we  account  in  some  measure  for  the  noticeable  increase  of 
horn  at  the  heels. 

Treatment — Chronic  laminitis  is  incurable.  Treatment 
must  therefore  be  directed  towards  the  palliation  of  such 
conditions  as  are  present,  with  the  object  of  rendering  the 
animal  better  able  to  perform  work.  "When  perforation 
of  the  sole  has  occurred,  with  the  attendant  formation  of 
pus  and  necrosis  of  the  os  pedis,  it  is  doubtful  whether 
treatment  of  any  kind  is  advisable.  There  are  on  record 
cases  of  this  description,  where  careful  curetting  of  the 
exposed  and  necrotic  portions  and  the  after  application  of 
antiseptic  dressings,  held  in  position  by  a  plate  shoe  or 
a  leather  sole,  has  been  followed  by  good  results,  and  the 
animal  restored  for  a  time  to  labour.  In  our  opinion,  how- 
ever, early  slaughter  is  the  most  economical  course  to 
adopt,  and  certainly  the  wisest  advice  to  give  to  the 
ordinary  client. 

When  perforation  of  the  sole  is  absent,  and  when  serious 
alteration  in  the  shape  of  the  horny  box  has  not  occurred, 
then  the  most  simple  treatment  is  to  put  the  animal 
straight  away  to  slow  work,  with  the  feet  protected  by 
suitable  shoes. 

Here,  again,  the  most  useful  shoe  is  the  Rocker  Bar 
(Fig.  119).  The  broad  web  and  deep  seating  gives  ample 
protection  to  the  convex  sole,  and  with  the  ease  in  dis- 
tributing his  weight  that  this  shoe  affords  the  animal  is 
able  to  perform  slow  work  on  soft  lands  with  some  degree 
of  comfort. 

Should  the  growth  of  the  horn  at  the  toe  and  at  the 
heels  be  unduly  excessive,  then  our  attention  may  be 
directed    towards    reducing    it    to    some    approach    to    the 


290 


DISEASES  OF  THE  HORSE'S  FOOT 


normal.  This  is  accomplished  by  removing  with  the  rasp 
and  the  knife  those  portions  indicated  by  the  dotted  lines 
in  Fig.  127.  Here  it  will  be  seen  that  the  bulk  of  the 
horn   removed   is   that  protruding  at   the   toe.     After   this 


Fig.  126.— Diagram  illustrating  the  Abnormal  Growth  of  Horn 
at  the  Toe  and  Heels  of  the  Foot  with  Chronic  Laminitis. 

the  animal  should  again  be  suitably  shod.  In  this  connec- 
tion it  should  be  noted  that  the  fact  of  the  animal  walking 
largely  on  the  heels  tends  to  a  forward  displacement  of  the 
shoe     This  must  be  prevented  by  providing  each  heel  of 


Fig.  127.— The  same  Foot  as  in  Fig.  126. 

The  dotted  lines  show  the  excess  of  horn  removed  preparatory  to 

shoeing. 
the  shoe  with  a  clip,  after  the  manner  shown  in  Fig.  128; 

or,  in  the  case  of  a  bar  shoe,  supplying  it  with  a  clip  at  the 

centre  of  the  bar. 

Among  other   treatments  to  be  noted  we  may  mention 


INFLAMMATORY  AFFECTIONS  291 

one  or  two  to  be  found  chiefly  in  Continental  works  on  this 
subject. 

The  method  of  Gross  consists  in  thinning  down  with  a 
rasp  about  H  inches  of  the  horn  of  the  wall  immediately 
below  the  coronet,  the  thinned  portion  extending  from  heel 
to  heel.  The  groove  made  is  filled  with  basilicon  ointment,* 
and  the  coronet  stimulated  with  a  cantharides  ointment. 
In  this  way  there  is  induced  to  grow  from  the  coronet  a  new 
wall  of  nearly  normal  dimensions. 

By  other  operators  (Bayer,  Imminger,  Meyer,  and 
Gunther)  this  treatment  has  been  modified  by  enlarging 
upon  it  and  removing  the  whole  of  the  adventitious  horn. 


Fig.   128.— The   Shoe  with   Heel-clip. 

This  is  done  by  means  of  the  drawing-knife  and  the  rasp, 
the  ugly-looking  pumiced  foot  being  carefully  cut  and 
trimmed  until,  so  far  as  outward  appearances  are  con- 
cerned, it  is  perfectly  normal.  This  done,  the  whole  foot 
is  treated  with  a  suitable  hoof  ointment,  and  a  shoe  applied 
that  affords  protection  to  the  sole  without  imposing  pressure 
upon  it.  The  shoe  indicated  is  either  an  ordinary  shoe 
with  an  unusually  broad  and  well-seated  web,  or  the  seated 
Rocker  Bar  of  Broad.     With  either  it  is  well  to  additionally 


*  Basilicon  ointment  is  made  by  heating  together  resin  8  parts, 
beeswax  8  parts,  olive  oil  8  parts,  and  lard  6  parts.  Allow  to  cool 
without  stirring. 


292         DISEASES  OF  THE  HORSE'S  FOOT 

protect  the  sole  by  means  of  a  leather  or  rubber  pad  and 
tar  stopping,  or  by  using  the  Hnrlederkitt  described  on 
p.  148.  In  every  case  the  nails  must  be  kept  well  back 
in  order  to  avoid  the  weakened  and  degenerated  horn  at 
the  toe,  and  to  take  advantage  of  the  greater  growth  of 
horn  at  the  heels. 

The  wisdom  of  thus  removing  the  whole  of  the  adventi- 
tious horn  may  be  questioned.  Although  a  foot  of  a  nearly 
normal  shape  is  obtained,  it  must  be  remembered  that  the 
grave  alterations  within  it  are  unchanged,  and  that  in  cer- 
tain positions  the  operation  must  have  carried  us  nearer 
the  sensitive  structures  than  is  advisable. 

All  other  treatments  failing,  the  operation  of  neurectomy 
has  been  advised.  This  we  do  not  think  wise.  One  would 
imagine  that,  with  degenerative  processes  already  going  on 
in  the  foot,  the  tendency  to  gelatinous  degeneration,  always 
to  be  looked  for  in  neurectomy,  would  be  increased.  This, 
as  a  matter  of  fact,  is  the  case,  and  is  borne  out  by  the 
statements  of  those  who  have  tried  this  method  of  treat- 
ment In  many  cases  the  lameness  even  is  not  got  rid  of. 
Even  where  it  is,  the  operation  is  afterwards  followed  by  a 
great  tendency  to  stumble,  by  sloughing  of  the  hoof,  or  by 
a  marked  increase  in  the  adventitious  horn,  and  a  conse- 
quent greater  deformity  of  the  foot. 

Sooner  than  risk  neurectomy,  it  seems  to  us  wiser  to  give 
a  trial  to  the  operation  advocated  by  M.  G.  Joly,  namely, 
that  of  ligaturing  one  of  the  digital  arteries  on  each  affected 
foot.  This  operation  is  performed  in  the  same  position  as 
is  the  higher  operation  of  plantar  neurectomy,  and  may  be 
either  internal  or  external.  The  vessel  is  exposed,  and  a 
double  ligature,  preferably  of  silk,  placed  on  it.  The  artery 
is  then  divided  between  the  two  ligatures.  The  immediate 
effect  of  the  operation  is  to  cause  a  considerable  diminution 
in  the  arterial  pressure,  and  so  lessen  the  intensity  of  the 
ostitis  in  the  os  pedis.  Its  consequences  are  not  so  serious 
as  those  of  neurectomy,  and  it  decongests  tissues  which 
neurectomy  congests. 

In  cases  related  by  M.  Joly  this  operation,  practised  both 


INFLAMMATORY  AFFECTIONS  293 

in  conjunction  with  removal  of  the  excess  of  horn  and  with- 
out it,  has  resulted  in  a  marked  improvement  in  the  gait, 
the  animal  going  to  work  one  month  after  the  treatment, 
and  remaining'  sound  for  some  time  afterwards. 


i& 


2.     Seedy-Toe. 

Definition. — A  defect  in  the  horn  of  the  wall,  usually  at 
the  toe,  but  occurring  elsewhere,  resulting  in  loss  of  its 
substance  in  either  its  internal  or  external  layers  (see 
Figs.  129,  130,  and  131). 

Causes. — The  most  common  factor  in  the  causation  of 
this  defect  is  undoubtedly  disease  of  the  sensitive  laminae. 
We  have,  in  fact,  just  given  an  excellent  example  of  the 
formation  of  a  seedy-toe  in  the  sections  of  this  chapter 
devoted  to  laminitis  (see  pp.  265  and  286).  The  cavity  here 
formed  by  the  outpouring  of  the  inflammatory  exudate  and 
the  separation  of  the  sensitive  and  horny  laminae  persists. 
It  becomes  filled  with  the  dried  remains  of  the  exudate  and 
perverted  secretions  from  the  horny  and  sensitive  laminae 
(see  p.  287).  As  yet,  however,  the  cavity  is  closed  below, 
and  its  existence  only  surmised.  Later,  with  successive 
visits  to  the  forge,  the  layer  of  solar  horn  forming  its  floor 
is  cut  away,  and  the  cavity  exposed  to  view.  Its  mealy- 
looking  contents  are  removed,  and  the  case  reported  by  the 
smith. 

Although  occurring  in  this  way  with  an  acute  attack  of 
laminitis,  it  must  be  remembered  that  seedy-toe  may  arise 
without  previous  noticeable  cause.  The  first  intimation 
the  owner  has  is  a  report  from  the  forge  that  seedy-toe  is 
in  existence.  To  refer  to  cases  so  arising  a  probable  cause 
is  far  from  easy.  At  one  time  it  was  believed  to  be  due  to 
parasitic  infection  of  the  horn.  Others  have  blamed  the 
pressure  of  the  toe-clip,  excessive  hammering  of  the  wall,  or 
pressure  from  nails  too  large  or  driven  too  close.  Others, 
again,  say  that  seedy-toe  may  result  from  a  prick  in  the 
forge,  from  hot-fitting  of  the  shoe,  from  standing  on  a  dry 
and  sandy  soil,  or  from  the  use  of  high  calkins  on  the 
front   shoes. 


294 


DISEASES  OF  THE  HORSE'S  FOOT 


In  these  cases — cases  with  an  insidious  onset — we  are 
inclined  to  the  opinion  that  the  disease  of  the  horn  com- 
mences from  below,  and  that  the  sensitive  laminae  become 
implicated  later.  Holding  this  view,  one  must  account  for 
the  commencing  disease  of  the  horn  by  giving,  as  causes, 
firstly,  those  factors  (as,  for  instance,  alternate  excessive 
dampness  and  dryness)  leading  to  disintegration  of  the 
horn  tubules ;  secondly,  the  penetrating  into  and  between 
the  degenerated  tubules  of  parasitic  matter  from  the  ground  ; 
and,  thirdly,  the  final  breaking  up  of  the  horn,  and  spread 
of  the  lesion  under  the  invasion  thus  started. 


Fig.   129.— Diagram  illustrating  Position  of  Seedy-Toe 
(Internal). 

i,  The  horn  of  the  wall;  2,  the  horn  of  the  sole;  3,  the  cavity  of 
seedy-toe ;  4,  the  os  pedis ;  5,  the  keratogenous  membrane. 

Symptoms. — Lameness  sometimes  attends  seedy-toe,  and 
sometimes  does  not.  This  is  an  important  point  to  be 
carried  in  mind  by  the  veterinary  surgeon  who  is  accus- 
tomed in  his  practice  to  have  many  animals  pass  through 
his  hands  for  examination  as  to  soundness.  An  animal 
with  advanced  seedy-toe — a  condition  constituting  serious 
unsoundness — may  walk  and  trot  absolutely  sound,  and 
may  give  no  indication,  either  in  the  shape  of  the  wall  or 
the  condition  of  the  sole,  that  anything  abnormal  is  in 
existence.  Later,  however,  after  the  veterinary  surgeon 
has  passed  him,  the  purchaser  lodges  the  complaint  that 
the  horse  has  a  bad  seedy-toe,  which,  so  he  is  told,  must 


INFLAMMATORY  AFFECTIONS 


295 


have  been  there  for  some  time.  In  this  case,  culpable 
though  he  may  appear,  there  is  every  excuse  for  the 
veterinary  surgeon. 

Once  the  cavity  is  opened  at  the  toe  in  the  neighbourhood 
of  the  white  line,  then  diagnosis  is  easy.  A  blunt  piece  of 
wood,  the  farrier's  knife,  or  a  director  may  be  easily  passed 
into  it,  sometimes  as  far  up  as  the  coronary  cushion  (see 
Fig.  129).  Issuing  from  the  opening  is  seen  occasionally 
a  little  inspissated  pus ;  more  often,  however,  the  dry, 
mealy-looking  detritus  to  which  we  have  before  referred. 
This  form  of  the  disease  we  may  term  '  Internal  Seedv-Toe,' 


Fig.  130.— External  Seedy-Toe 
commencing  at  the  Plantar 
Border  of  the  Wall. 


Fig.  131.— External  Seedy-Toe 
commencing  on  the  Anterior 
Face  of  the  Wall. 


for,  plainly  enough,  it  has  had  its  origin  in  chronic 
inflammatory  changes  in  the  keratogenous  membrane. 

Disease  of  the  horn  and  loss  of  its  substance  may,  how- 
ever, also  commence  from  without.  A  report  on  this  con- 
dition, under  the  title  of  '  External  Seedy-Toe,'  is  to  be 
found  in  vol.  xxix.  of  the  Veterinary  Journal,  from  which 
we  borrow  Figs.  130  and  131. 

In  Fig.  130  it  will  be  seen  that  the  disease  commences  at 
the  plantar  surface  of  the  toe,  and  extends  upwards  and 
inwards.  The  same  condition  may  also  appear  anywhere 
between  the  coronet  and  the  ground,  gradually  extending 
into  the  substance  of  the  wall,  as  shown  in  Fig.  131. 
According  to  the  writer.  Colonel  Nunn,  the  progress  of  the 
disease  in  this  latter  case  appears  to  be  faster  in  a  downward 


296  DISEASES  OF  THE  HORSE'S  FOOT 

than  in  an  upward  direction.  This,  however,  is  more 
apparent  than  real,  as  the  rate  of  growth  of  the  horn  down- 
wards detracts  from  the  progress  of  the  disease  upwards, 
although  it  spreads  over  the  horn  at  the  same  rate. 

Before  concluding  the  symptoms,  we  may  again  allude  to 
the  fact  that,  although  usually  occuring  at  the  toe,  the 
same  condition  may  be  met  with  in  other  positions — namely, 
at  either  of  the  quarters.  In  appearance  and  in  other 
respects  it  is  identical  with  that  occurring  at  the  toe. 

When  the  animal  is  lame  and  the  existence  of  seedy-toe 
is  surmised,  or  when  the  cause  of  the  lameness  is  altogether 
obscure,  a  little  information  may  perhaps  be  gathered  from 
noting  the  wear  of  the  shoe.  If  the  animal  has  been  going 
lame  for  any  length  of  time  as  a  result  of  disease  in  the 
sensitive  laminae,  then  the  shoe  will  be  greatly  thinned  at 
the  heels,  and  the  toe  but  little  worn. 

Treatment. — As  with  diseased  structures  elsewhere,  the 
most  rational  treatment,  when  possible,  is  that  of  excision. 
The  entire  portion  of  the  wall  forming  the  anterior  boundary 
of  the  cavity  is  thinned  down  with  the  rasp  and  afterwards 
removed  with  the  knife,  wholly  exposing  the  hypertrophied, 
but  usually  soft  layer  of  horn  covering  the  sensitive 
structures.  These  hypertrophied  portions  are  also  removed, 
and  every  particle  of  the  dust-like  detritus  cleaned  away. 
After-treatment  consists  in  dressing  the  parts  with  a  good 
hoof  ointment,  protecting  them,  if  necessary,  with  a  pad  of 
tow  and  a  stout  bandage.  It  may  be  that  the  removal  of 
a  large  portion  of  the  wall  may  for  some  time  throw  the 
animal  out  of  work.  Acting  on  Colonel  Fred  Smith's 
suggestion,  this  may  be  avoided  by  having  made  a  thin 
plate  of  sheet-iron,  slightly  larger  in  circumference  than  the 
portion  of  horn  removed,  and  shaped  to  follow  the  contour 
of  the  foot.  This  made,  it  is  sunk  flush  with  the  wall  by 
hot-fitting  it,  and  kept  in  position  by  several  small  steel 
screws  fixed  into  the  sound  horn,  just  as  in  the  treatment 
for  sand-crack  (see  p.  174).  This  will  serve  the  useful 
purpose  of  maintaining  in  position  any  dressing  that  may 
be  thought  necessary,  of  acting  as  a  support  to  the  horn 


INFLAMMATORY  AFFECTIONS  297 

left  on  each  side  of  the  portion  removed,  and  of  keeping  the 
exposed  structures  free  from  dirt  and  grit. 

Practical  points  to  be  remembered  in  fitting  plates  of  this 
description  to  the  feet  are :  The  plate  must  never  quite 
reach  the  shoe,  or  it  will  participate  in  the  concussion  of 
progression,  and  so  loosen  the  screws  that  hold  it  in  place. 
For  the  same  reason,  that  portion  of  the  sole  adjoining  the 
piece  of  horn  removed  must  have  its  bearing  on  the  shoe 
relieved.  The  screws  holding  the  plate  should  be  oiled  to 
prevent  rusting,  and  should  take  an  oblique  direction  in 
order  to  obtain  as  great  a  hold  as  possible  on  the  wall. 

When  excision  is  deemed  unwise  or  unnecessary,  treat- 
ment should  be  directed  towards  maintaining  the  cavity  in 
a  state  of  asepsis.  To  this  end  it  should  be  thoroughly 
cleaned  of  its  contents,  and  afterwards  dressed  with  medicated 
tow.  The  ordinary  tar  and  grease  stopping  is  as  suitable  as 
any.  This,  together  with  the  tow,  is  tightly  plugged  into 
the  opening  and  kept  in  position  by  a  wide-webbed  shoe. 
Instead  of  the  tar  stopping  and  the  tow,  there  may  be  used 
with  advantage  the  artificial  hoof-horn  of  Defay  (see  p. 
152).  Before  using  this  the  cavity  should  again  be  thor- 
oughly cleaned  out,  and  should  in  addition  be  mopped  out 
with  ether.  The  latter  injunction  is  important,  as  unless 
the  grease  is  thus  first  removed,  the  composition  will  fail  to 
adhere  to  the  horn.  With  the  cavity  thus  cleaned  and 
prepared,  the  artificial  horn,  melted  ready  to  hand,  is  poured 
into  it  and  allowed  to  set. 

In  every  case,  no  matter  what  else  the  treatment,  the 
bearing  of  the  horn  adjacent  to  the  lesion  should  be  removed 
from  the  shoe. 

Whether  practising  the  method  of  plugging  the  cavity  or 
that  of  excision  of  the  wall  external  to  it,  attempts  to  quickly 
obtain  a  new  growth  of  horn  from  the  coronet  should  be 
made.  To  further  that,  frequent  stimulant  applications 
should  be  used.  Ointment  of  Biniodide  of  Mercury  1  in  8, 
of  Cantharides  1  in  8,  or  the  ordinary  Oil  of  Cantharides, 
either  will  serve. 


298         DISEASES  OF  THE  HORSE'S  FOOT 

3.     Keraphyllocele. 

Definition. — By  this  term  is  indicated  an  enlargement 
forming  of  the  inner  surface  of  the  wall.  In  shape  and 
extent  these  enlargements  vary.  Usually  they  are  rounded 
and  extended  from  the  coronary  cushion  to  the  sole,  some- 
times only  as  thick  as  an  ordinary  goose-quill,  at  other  times 


Fig.  132.— A  Portion  of  the  Horn  of  the  Wall  at  the  Toe 
removed  in  order  toi  show  a  Keraphyllocelle  on  its  Inner 
Surface. 

reaching  the  size  of  one's  finger.     Often  they  are  irregular 
in  formation  and  flattened  from  side  to  side. 

Causes. — Keraphyllocele  is  very  often  a  sequel  to  the 
changes  occurring  at  the  toe  in  laminitis.  Probably,  how- 
ever, the  most  common  cause  is  an  injury  upon,  or  a  crack 


INFLAMMATORY  AFFECTIONS  299 

through,  the  wall.  It  may  thus  occur  from  excessive 
hammering  of  the  foot,  from  violent  kicking  against  a 
wall  or  the  stable  fittings,  and  from  the  injury  to  the  coronet 
known  as  '  tread.'  It  may  also  occur  as  a  sequel  to  com- 
plicated sand-crack,  and  to  chronic  corn. 

That  fissures  in  the  wall  are  undoubtedly  a  cause  has 
been  placed  on  record  by  the  late  Professor  Walley,  who 
noticed  the  appearance  of  these  horny  growths  following 
upon  the  operation  of  grooving  the  wall.* 

This  gentleman  had  a  large  Clydesdale  horse  under  his 
care  for  a  bad  sand-crack  in  front  of  the  near  hind-foot, 
and,  as  the  lameness  was  extreme,  he  adopted  his  usual 
method  of  treatment — viz.,  rest,  fomentations,  poulticing, 
and  the  making  of  the  V  -shaped  section  through  the  wall, 
and  subsequently  the  application  of  an  appropriate  bar  shoe 
to  the  foot,  and  repeated  blisters  to  the  coronet.  In  a 
short  time  the  lameness  passed  off,  and  the  horse  was  put 
to  work.  A  few  days  later  the  animal  met  with  an  accident, 
and  was  killed. 

On  examining  a  section  of  the  hoof  it  was  found  that 
a  vertical  horny  ridge  corresponding  to  the  external  fissure 
had  been  formed  on  the  internal  surface  of  the  wall,  and 
that  a  well-marked  cicatrix  extended  upwards  through  the 
structure  of  the  hoof  at  the  part  forming  the  cutigeral 
groove;  furthermore,  a  similar  ingrowth  had  been  taking 
place  in  the  line  of  the  oblique  incisions  made  for  the  relief 
of  the  sand-crack. 

This  case  has  an  important  bearing  on  the  operation  of 
grooving  the  wall,  which  operation  we  have  several  times  in 
this  work  advocated  for  the  relief  of  other  diseases.  It 
teaches  us  that  the  incisions  should  not  be  carried  so  com- 
pletely through  the  horn  as  to  interfere  with  and  irritate  the 
sensitive  laminae,  and  so  set  up  the  chronic  inflammatory 
condition  leading  to  hyperthrophy  of  the  horn. 

From  the  position  on  the  os  pedis  of  the  indentation  made 
in  it  by  the  keraphyllocele  (see  Fig.  133)  it  has  been  argued 

*  Journal  of  Comparative  Pathology  and  Therapeutics,  vol.  iii., 
p.    170. 


300        DISEASES  OF  THE  HORSE'S  FOOT 

that  pressure  of  the  toe-clip  is  a  cause  of  the  new  growth. 
This,  we  should  say,  cannot  be  a  very  strong  factor  in  the 
causation,  for,  while  we  admit  that  the  continual  pressure 
of  the  clip,  and  the  heavy  hammering  that  sometimes  fits  it 
into  position,  is  likely  to  set  up  a  chronic  inflammatory 
condition  of  the  sensitive  laminse  in  that  region,  we  must 
still  point  out  that  the  rarity  of  keraphyllocele,  as  compared 
with  the  fact  that  clips  are  on  every  shoe,  does  not  allow  of 
the  argument  carrying  any  great  weight. 

Symptoms. — Except  under  certain  conditions  this  defect 
is  difficult  of  detection.  As  a  rule,  lameness  is  not  produced 
by  it.  In  making  that  statement  we  are  led  largely  by  the 
conclusion  arrived  at  by  Professor  Walley.  This  observer 
noted  the  fact  that  ingrowths  of  horn  such  as  we  are 
describing  nearly  always  take  place  in  false  quarter,  or 
after  a  sand-crack  has  been  repaired,  and  that  they  com- 
monly occur  after  the  operation  of  grooving  the  wall  in  the 
manner  we  have  just  shown. 

Now,  we  know  that  quite  often  under  these  circumstances 
the  horse  goes  perfectly  sound.  Thus,  while  we  know  that 
in  all  probability  keraphyllocele  is  in  existence,  we  have 
ocular  demonstration  that  the  animal  is  quite  unaffected 
by  it. 

In  some  cases,  however,  lameness  is  present.  During 
the  early  stages  of  the  growth's  formation  it  is  but  slight, 
increasing  as  the  keraphyllocele  enlarges.  Should  this  be 
the  case,  other  symptoms  present  themselves.  The  coronet 
is  hot,  and  tender  to  the  touch,  sometimes  even  perceptibly 
swollen,  and  percussion  over  the  wall  is  met  with  flinching 
on  the  part  of  the  animal-  In  other  cases  one  is  led  to 
suspect  the  condition  by  the  prominence  of  the  horn  of 
the  wall  of  the  toe.  This  is  distinctly  ridge-like  from  the 
coronet  to  the  ground,  while  on  either  side  of  it  the  quarters 
appear  to  have  sunk  to  less  than  their  normal  dimensions. 
We  believe  this  to  be  an  illusion,  as  a  ridge  of  any  size 
at  the  toe  readily  gives  one  the  impression  of  atrophy  behind 
it,  without  this  latter  condition  being  actually  present. 

Should  this  ridge-like  formation  and  the  accompanying 


INFLAMMATORY  AFFECTIONS  301 

symptoms  of  pain  and  lameness  occur  after  repair  of  a  sand- 
crack,  then  keraphyllocele  may,  with  tolerable  certainty,  be 
diagnosed.  When  these  outward  signs  are  wanting,  how- 
ever, and  the  true  nature  of  our  case  is  a  matter  of  mere 
conjecture,  a  positive  diagnosis  may  still  be  made  at  a  later 
stage — that  is,  when  the  abnormal  growth  of  horn  reaches 
the  sole.  In  this  case  either  there  is  met  with  when  paring 
the  sole  a  small  portion  of  horn,  circular  in  form,  distinctly 
harder  than  normal,  and  indenting  in  a  semicircular  fashion 
the  front  of  the  white  line  at  the  toe,  or  solution  of  con- 
tinuity between  the  tumor  and  the  edge  of  the  sole  and  the 
os  pedis  takes  place,  and  the  lameness  resulting  from  the 
ingress  of  dirt  and  grit  thus  allowed  draws  attention  to  the 
case. 

Pathological  Anatomy. — With  the  sensitive  structures 
removed  from  the  hoof  by  maceration  or  other  means,  these 
growths  are  at  once  apparent.  They  may  occur  in  any 
position,  but  are  usually  seen  at  the  toe,  and  they  may 
extend  from  the  coronary  cushion  to  the  sole,  or  they  may 
occupy  only  the  lower  or  the  upper  half  of  the  wall.  In 
places  the  tumour  (or  'horny  pillar  '  as  the  Germans  term 
it)  is  roughened  by  offshoots  from  it,  and  does  not  always 
exhibit  the  smooth  surface  depicted  in  Fig.  132.  Commonly, 
the  horn  composing  the  new  growth  is  hard  and  dense. 
Sometimes,  however,  it  is  soft  to  the  knife,  and  is  then 
found  to  be  itself  fistulous  in  character,  a  distinct  cavity 
running  up  its  centre,  from  which  issues  a  black  and 
offensive  pus. 

In  a  few  cases  the  sensitive  laminae  in  the  immediate 
neighborhood  are  found  to  be  enlarged,  but  in  the  majority 
of  cases  atrophy  is  the  condition  to  be  observed.  Xot  only 
are  the  sensitive  structures  found  to  be  shrunken  and 
absorbed,  but  the  atrophy  and  absorption  extends  even 
to  the  bone  itself  (see  Fig.  133).  This  latter  is  a  result 
of  the  continued  pressure  of  the  horny  growth,  in  a  well- 
marked  case  ending  in  a  sharply-defined  groove  in  the 
os  pedis  in  which  the  keraphyllocele  rests.  The  fact  that 
the  softer  structures,   and  even  the  bone,  thus  accommo- 


302  DISEASES  OF  THE  HORSE'S  FOOT 

date  themselves  to  the  altered  conditions  is,  no  doubt,  the 
reason  that  lameness  in  many  of  these  cases  is  absent. 

Treatment. — It  is  doubtful  whether  anything  satisfactory 
can  be  recommended.  When  we  have  suspected  this  condi- 
tion ourselves,  it  has  been  our  practice  to  groove  the  hoof 
on  either  side  of  the  toe,  after  the  manner  illustrated  in 
Fig.  120,  and,  at  the  same  time,  point-firing  the  coronet 
and  applying  a  smart  cantharides  blister.  Certainly,  after 
this  operation,  lameness  has  often  disappeared — whether, 
however,  as  a  result  of  the  treatment  adopted  or  by  reason 
of  the  structures  within  accommodating  themselves  to  the 
condition,  we  would  not  care  to  say. 


Fig.  133. — Os  Pedis  showing  the  Groove  in  it  caused  by  Atrophy 
and  Absorption  induced  by  Pressure  of  a  Keraphyllocele. 

Other  writers  advocate  the  removal  of  that  portion  of  the 
wall  to  which  the  tumor  is  attached,  after  the  manner 
described  on  p.  182,  and  illustrated  in  Fig.  98.  This,  how- 
ever, should  be  a  last  resource,  and  should  be  adopted  only 
when  weighty  reasons,  such  as  excessive  and  otherwise  in- 
curable lameness,  appear  to  demand  it. 

4.  Keratoma. 

In  our  nomenclature  the  terms  '  Keratoma  '  and  '  Kera- 
phyllocele '  are  both  used  to  indicate  the  condition  we  have 
just  described.  There  are  some,  however,  who  reserve  the 
term  *  Keratoma  '  for  horny  tumors  occurring  only  on  the 
sole,  and  for  that  reason  we  draw  special  attention  to  the 


INFLAMMATORY  AFFECTIONS.  303 

word  here.  Keratoma  may  thus  be  used  to  describe  what 
we  have  called  keraphyllocele  directly  that  growth  makes 
its  appearance  at  the  sole,  and  is  there  able  to  be  cut  with 
the  knife.  Similar  hard  and  condensed  growths  may,  how- 
ever, make  their  appearance  on  the  sole  in  other  positions 
quite  removed  from  the  white  line,  plainly  being  secreted 
by  the  villous  tissue  of  the  sensitive  sole,  and  having  no 
connection  whatever  with  the  sensitive  laminae.  They 
appear  as  circular  patches,  varying  in  size  from  a  shilling 
to  a  two-shilling  piece.  Compared  with  the  surrounding 
horn,  they  stand  out  white  and  glistening,  while  in  struc- 
ture they  are  dense  and  hard,  and  offer  a  certain  amount 
of  resistance  to  the  knife.  They  are  of  quite  minor  impor- 
tance, and,  beyond  keeping  them  well  pared  down,  need  no 
attention.  Keratoma  probably  offers  us  the  best  analogy 
we  have  to  corn  of  the  human  subject. 

5  Thrush. 

Definition. — A  disease  of  the  frog  characterized  by  a  dis- 
charge from  it  of  a  black  and  offensive  pus,  and  accom- 
panied by  more  or  less  wasting  of  the  organ. 

Causes. — The  primary  cause  of  this  affection  is  doubtless 
the  infection  of  the  horn,  and  later  the  sensitive  structures, 
with  matter  from  the  ground.  Those  factors,  therefore, 
leading  to  deterioration  of  the  horn,  and  so  exposing  it  to 
infection,  may  be  considered  here.  Such  will  be  changes 
from  excessive  dampness  to  dryness,  or  vice  versa;  work 
upon  hard  and  stony  roads ;  prolonged  standing  in  the 
accumulated  wet  and  filth  of  insanitary  stables,  or  long 
standing  upon  a  bedding  which,  although  dry,  is  of  unsuit- 
able material. 

In  this  latter  connection  may  be  mentioned  the  harm 
resulting  from  the  use  of  certain  varieties  of  moss  litter. 
This  we  find  pointed  out  by  J.  Roalfe  Cox,  F.R.C.V.S.* 
Tenderness  in  the  foot  was  first  noticed,  and,  on  examina- 
tion, the  horn  of  the  sole  and  of  the  frog  was  found  to  be 

*   Veterinary  Journal,  vol.  xvi.,  p.  243. 


304        DISEASES  OF  THE  HORSE'S  FOOT 

peculiarly  softened.  It  afforded  a  yielding  sensation  to  the 
finger,  not  unlike  that  which  is  imparted  by  indiarubber, 
and  on  cutting  the  altered  horn  it  was  almost  as  easily 
sliced  as  cheese-rind.  The  outer  surface  being  in  this  way 
slightly  pared  off,  the  deeper  substance  of  the  horn  was  dis- 
coloured by  a  pinkish  stain.  The  horn  of  the  frog  was  in 
many  instances  found  detaching  from  the  vascular  surface, 
which  was  very  disposed  to  take  on  a  diseased  action,  some- 
what allied  to  canker,  and  became  extremely  difficult  to 
treat. 

Conditions  such  as  these,  although  not  constituting  the 
disease  itself,  certainly  lay  the  frog  open  to  infection, 
especially  if  afterwards  the  animal  is  called  upon  to  work 
in  the  mud  of  the  streets  of  a  large  town,  or  to  stand  in  a 
badly  drained  and  damp  stable. 

A  further  cause  of  thrush  is  to  be  found  in  the  condition 
of  the  frog,  brought  about  by  contraction  of  the  heels  (see 
p.  118).  We  have  already  seen  that  one  of  the  most  promi- 
nent factors  in  the  causation  of  contraction  is  the  removal 
of  the  frog  from  the  ground  by  shoeing,  with  its  consequent 
diminution  in  size  and  deterioration  in  quality  of  horn. 
This  leads  to  fissures  in  the  horny  covering,  and  favours 
infection  of  the  sensitive  structures  beneath.  Thrush  is,  in 
fact,  nearly  always  present  in  the  later  stages  of  contracted 
foot. 

By  some  thrush  is  believed  to  be  but  the  commencement 
of  canker.  With  this,  however,  we  do  not  hold.  We 
believe  both  to  be  due  to  specific  causes  as  yet  undis- 
covered, but  that  the  cause  of  thrush  is  not  the  one  operat- 
ing in  canker.  In  arriving  at  this  conclusion  we  are  guided 
by  clinical  evidence.  The  two  .conditions  are  quite  dis- 
similar, even  in  appearance,  and,  while  one  is  readily 
amenable  to  treatment,  the  other  is  just  as  obstinately 
resistant. 

Symptoms. — The  symptoms  of  thrush  are  always  very 
evident.  Probably  the  first  thing  that  draws  one's  atten- 
tion to  it  is  the  stench  of  the  puriform  discharge.  The  foot 
is  then  picked  up  and  the  characteristic  putrescent  matter 


INFLAMMATORY  AFFECTIONS.  305 

found  to  be  accumulated  in  the  median,  and  often  in  the 
lateral,  lacuna?.  The  organ  is  wasted  and  fissured,  the 
horn  in  the  depths  of  the  lacunae  softened  and  easily  de- 
tachable, and  portions  of  the  sensitive  frog  often  laid 
bare. 

With  a  bad  thrush  lameness  is  present,  the  frog  itself  is 
tender  to  pressure,  and  often  there  is  considerable  heat  and 
tenderness  of  the  heels  and  the  coronet  immediately  above. 
More  especially  is  this  noticeable  after  a  journey. 

It  is,  perhaps,  more  common  in  the  hind-feet  than  in  the 
fore,  and  more  often  met  with  in  heavy  draught  animals 
than  in  nags.  The  hind-feet  are,  of  course,  more  open  to 
infection  by  reason  of  their  being  constantly  called  upon  to 
stand  in  the  animal  discharges  in  the  rear  of  stable  stand- 
ings, while  it  is  a  well-known  fact  that  heavy  animals  have 
their  stables  kept  far  less  clean,  and  their  feet  less  assidu- 
ously cared  for,  than  do  animals  of  a  lighter  type. 

In  a  nag-horse  with  thrush  of  both  fore-feet  lameness 
becomes  sometimes  very  great.  The  gait  when  first  moved 
out  from  the  stable  is  feeling  and  suggestive  of  corns,  while 
progress  on  a  road  with  loose  stones  is  sometimes  posi- 
tively dangerous  to  the  driver. 

Treatment. — When  this  condition  has  arisen,  as  it  often 
does,  from  want  of  counter-pressure  of  the  frog  with  the 
ground,  this  pressure  must  be  restored  after  the  manner 
described  when  dealing  with  the  treatment  of  contracted 
foot  (see  p.  125)  either  by  the  use  of  tip  or  bar  shoes,  or 
by  suitable  pads  and  stopping. 

So  far  as  direct  treatment  of  the  lesion  itself  is  concerned, 
the  first  step  is  to  carefullly  trim  away  all  diseased  horn 
and  freely  open  up  the  lacunae  in  which  the  discharge  has 
accumulated.  Good  results  are  then  often  arrived  at  by 
poulticing,  afterwards  followed  up  by  suitable  antiseptic 
dressings.  With  us  a  fovourite  one  is  the  Sol.  Hydrarg. 
Perchlor.  of  Tuson,  used  without  dilution.  Others  use  a 
dry  dressing,  and  dust  with  Calomel,  with  a  mixture  of 
Sulphate  of  Copper,  Sulphate  of  Zinc  and  Alum,  or  with 
Subacetate  of  Copper  and  Tannin. 


306        DISEASES  OF  THE  HORSE'S  FOOT 

With  restoration,  so  far  as  is  possible,  of  the  frog  functions, 
and  with  careful  dressing,  a  cure  is  nearly  always  obtained. 

6.  Canker. 

Definition. — Under  this  unscientific,  yet  expressive  term, 
is  indicated  a  chronic  diseased  condition  of  the  keratogen- 
ous  membrane,  commencing  always  at  the  frog,  and  slowly 
extending  to  the  sole  and  wall,  characterized  by  a  loss  of 
normal  function  of  the  horn  secreting  cells,  and  the  dis- 
charge of  a  serous  exudate  in  the  place  of  normal  horn. 

Causes. — The  exact  cause  of  canker  has  still  to  be  dis- 
covered. Therefore,  before  expressing  an  opinion  as  to 
what  the  probable  cause  may  be,  we  may  dState  here  that 
such  opinion  can  only  be  based  upon  clinical  observation. 
Such  being  the  case,  we  are  almost  duty  bound  to  give  the 
views  of  older  authors  before  those  of  more  modern  writers. 

From  the  mass  of  material  ready  to  hand  we  may  select 
the  following  as  serving  our  purpose. 

The  earliest  opinion  appears  to  have  been  that  canker,  as 
the  name  indicates,  was  of  a  cancerous  or  cancroid  nature. 
This  was  also  believed  by  Hurtrel  D'Arboval,  who  looked 
upon  canker  as  carcinoma  of  the  recticular  structure  of  the 
foot.  The  same  theory  we  find  enunciated  in  the  Veterinary 
Journal  so  late  as  1890.  Although  the  word  '  cancer '  or 
'  carcinoma '  is  not  there  used,  the  author  employs  the 
terms  '  Papilloma '  and  '  Epithelioma '  with  the  evident 
intention  of  expressing  his  belief  in  the  malignant  nature  of 
the  disease. 

Another  early  opinion  was  that  the  disease  was  a  spread- 
ing ulcer,  gradually  extending  and  changing  the  tissues 
which  it  invaded. 

A  further  early  theory,  and  one  which  if  not  still  believed 
in,  has  died  a  hard  death,  is  the  constitutional  theory.  This 
was  believed  in  by  nearly  all  the  older  writers,  and  is 
mentioned  so  late  as  1872  by  the  late  Professor  Williams. 
In  his  '  Principles  and  Practice  of  Veterinary  Surgery/  he 
says :  "Canker  is  a  constitutional  disease  due  to  a  cachexia 
or  habit  of  body,  grossness  of  constitution,  and  lymphatic 


INFLAMMATORY  AFFECTIONS.  307 

temperament.'  This,  we  believe,  is  credited  to-day  by  some, 
and  yet,  quite  100  years  before  the  date  of  the  1872  edition 
of  Williams's  work — in  1756,  to  be  exact — we  find  a  vet- 
erinary writer  when  talking  of  grease  (a  disease,  by-the-by, 
very  closely  allied  to  canker )  exclaiming  against  this  habit 
of  referring  everything  which  we  do  not  rightly  understand 
to  some  ill-humour  of  the  body.  The  wisdom  his  words  con- 
tain justifies  us  in  giving  them  mention  here.  '  It  is  a  very 
foolish  and  absurd  Notion/  he  says,  '  to  imagine  a  Horse 
full  of  Humours  when  he  happens  to  be  troubled  with  the 
Grease.  But  such  Shallow  Reasoning  will  always  abound 
while  Peoples'  Judgments  are  always  superficial.  There- 
fore, to  convince  such  unthinking  Folks,  let  them  take  a 
thick  Stick  and  beat  a  Horse  soundly  upon  his  Legs  so  that 
they  bruise  them  in  several  Places,  after  which  they  will 
swell,  I  dare  say,  and  yet  be  in  no  danger  of  Greasing. 
Now,  pray,  what  were  these  offending  Humours  doing  be- 
fore the  Bruises  given  by  the  Stick?' 

At  the  present  day  it  is  safe  to  assert  that  neither  the 
ulcerative,  the  cancerous,  nor  the  constitutional  theory 
is  believed  in  widely,  and,  among  the  mass  of  contrary 
opinions  as  to  the  cause  of  this  disease,  we  may  find  that 
even  quite  early  many  of  the  older  writers  had  discarded 
them. 

Quoting  from  Zundel,  we  may  say  that  Dupuy  in  1827 
considered  canker  as  a  hypertrophy  of  the  fibres  of  the  hoof, 
admitting  at  the  same  time  that  these  fibres  were  softened 
by  an  altered  secretion;  while  Mercier  in  1841  stated  that 
canker  was  nothing  more  than  a  chronic  inflammation  of 
the  reticular  tissue  of  the  foot,  characterized  by  diseased 
secretions  of  this  apparatus. 

Saving  that  they  make  no  mention  of  a  likely  specific 
cause,  these  last  two  statements  express  all  that  we  believe 
to-day.  As  early  as  1854,  however,  the  existence  of  a 
specific  cause  was  hinted  at  by  Blaine  in  his  '  Veterinary 
Art.'  We  find  him  here  describing  canker  as  a  fungoid 
excrescence,  exuding  a  thin  and  offensive  discharge,  which 
inoculates  the  soft  parts  within  its  reach,  particularly  the 


308        DISEASES  OF  THE  HORSE'S  FOOT 

sensitive  frog  and  sole,  and  destroys  their  connections  with 
the  horny  covering. 

The  use  of  the  word  '  fungoid/  and  particularly  that  of 
'  inoculate,'  is  suggestive  enough,  and  is  evidence  sufficient 
that  either  Blaine  or  his  editor  recognised,  simply  through 
clinical  observation,  the  working  of  a  special  cause. 

Four  years  later,  Bouley  is  found  holding  the  opinion  that 
canker  was  closely  allied  to  tetter,  thus  recognising  for  it 
a  local  specific  cause.  The  same  observer  also  pointed  out 
that  the  secretion  of  the  keratogenous  membrane  instead 
of  being  suspended  was  greatly  increased,  taking  care  to 
explain,  as  did  Dupuy,  that  the  products  of  the  secretion 
were  perverted  and  had  lost  their  normal  ability  to  become 
transformed  into  compact  horn. 

In  1864  this  slowly  growing  recognition  of  a  specific 
cause  received  further  impetus  from  the  statements  of 
Megnier.  This  observer  claimed  to  have  discovered  in  the 
cankerous  secretions  the  existence  of  a  vegetable  parasite 
(namely,  a  cryptogam,  as  in  favus),  which  he  termed  the 
keraphyton,  or  parasitic  plant  of  the  horn. 

Modern  research,  though  failing  to  substitute  anything 
more  definite,  has  not  confirmed  this.  The  exact  and  ex- 
citing cause  of  canker  is  therefore  still  an  open  question, 
and  a  matter  for  research.  We  may,  however,  sum  the 
matter  up  by  briefly  discussing  the  causes,  so  far  as  clinical 
observation  teaches  us.  This  we  shall  do  under  two  head- 
ings— namely,  Predisposing  and  Exciting. 

Predisposing  Causes. — Starting  with  the  assumption  that 
the  disease  is  due  to  local  infection,  we  may  relate  as  pre- 
disposing causes  anything  having  a  prejudicial  effect  upon 
the  horn,  disintegrating  it,  and  so  laying  the  tissues  beneath 
open  to  attack.  The  most  prominent  in  this  connection  is 
certainly  a  continued  dampness  of  the  material  on  which 
the  animal  has  to  stand.  Particularly  is  this  the  case 
when  the  material  is  also  excessively  foul  and  dirty,  con- 
taminated with  the  animal  discharges,  and  presumably 
swarming  with  the  lower  forms  of  animal  and  plant  life. 
We   shall   therefore   find   bad   cases   of   canker   in   stables 


INFLAMMATORY  AFFECTIONS  309 

where  the  "  sets  "  are  irregular,  or  where  no  paving  at  all 
is  attempted,  where  the  drainage  is  defective,  and  where 
darkness  and  want  of  proper  ventilation  favours  organismal 
growth.  The  fact  that  with  modern  drainage  and  a  general 
hygienic  improvement  is  stabling,  canker  has  to  a  large 
extent  died  out,  supports  this  contention. 

Again,  as  with  thrush,  anything  removing  the  counter- 
pressure  of  the  frog  with  the  ground  and  throwing  that 
organ  out  of  play,  may  be  looked  upon  as  a  predisposing 
cause.  The  atrophy  of  the  frog  thus  occurring,  the  de- 
terioration in  the  quality  of  its  horn  and  the  fissures  in  its 
surface  lay  it  specially  open  to  infection.  That  one  of  the 
principal  factors  in  the  treatment  of  canker  is  a  restoration 
of  ground-pressure  to  the  frog  and  the  sole  is  sufficient 
proof  of  this. 

Further,  it  is  well  to  note  that,  although  playing  no 
part  in  the  actual  causation,  certain  constitutional  con- 
ditions may  in  some  measure  predispose  the  foot  to  attack. 
Clinical  observation  teaches  us  that  animals  of  a  lymphatic 
nature,  with  thick  skins  and  an  abundance  of  hair,  with 
fiat  feet  and  thick,  fleshy  frogs,  are  far  more  liable  to 
attack  than  are  animals  with  reverse  points. 

Exciting  Causes. — Those  who  give  this  subject  careful 
consideration  cannot  fail  to  arrive  at  the  conclusion  that 
canker  is  most  certainly  due  to  local  infection  with  a 
specific  poison,  and  that  poison  a  germicidal  one  from  the 
ground.  The  symptoms  arising  may  be  due  to  the  action 
of  a  single  germ,  or  to  two  or  more  germs  acting  in  con- 
junction. As  to  whether  the  parasitic  invasion  is  single  or 
multiple  we  cannot  feel  certain,  but  that  it  is  parasitic  we 
feel  absolutely  assured. 

It  is  simply  the  light  that  bacteriological  advance  has 
made  during  the  last  two  decades  that  enables  us  to  make 
the  statement  with  such  feelings  of  assurance.  We  arrive 
at  our  conclusions  by  reasoning  from  analogy.  Here  we 
have  a  disease  always  exhibiting  the  same  symptoms,  more 
or  less  peculiar  to  one  class  of  animal,  always  with  a 
similar  characteristic  appearance  and  smell,  always  obsti- 


310        DISEASES  OF  THE  HORSE'S  FOOT 

nately  refractory  to  treatment,  showing  always  a  tendency 
to  spread  to  the  other  feet  of  the  same  animal,  and  often 
to  the  feet  of  other  animals  near  enough  to  become  infected, 
and  always  cured — when  cured  it  is — by  a  treatment  which 
may  be  summed  up  in  two  words  as  '  rigid  antisepsis.' 
Other  diseases,  with  points  in  common  with  this,  have 
been  directly  proved  to  be  due  to  a  specific  cause.  Common 
regard  for  logic  compels  us  to  admit  the  same  for  canker. 


Fig.  134. — A  Foot,  the  Subject  of  Canker,  showing  Destruction 
of  the  Horny  Frog,  and  a  Fungoid-looking  Hypertrophy  of 
the  Tissues  Beneath. 


Symptoms  and  Pathological  Anatomy. — The  symptoms  of 
canker  are  seldom  noticeable  at  the  commencement  of  an 
attack.  The  disease  is  slow  in  its  progress ;  for  some  time 
confines  its  ravages  to  the  subhorny  tissues,  unseen,  and  is 
quite  unattended  with  pain.  It  is  not  observed,  therefore, 
until  considerable  damage  has  been  done,  and  the  disease 
is  far  advanced.  What  is  usually  first  seen  is  a  peculiar 
softening  and  raising  of  the  horn  of  the  frog.  The  in- 
fective material  has  set  up  a  chronic  inflammation  of  the 


INFLAMMATORY  AFFECTIONS  311 

keratogenous  membrane,  leading  to  abnormal  secretion, 
and,  in  place  of  the  horny  cells  it  should  normally  secrete, 
is  thrown  out  an  abundance  of  a  serous  fluid. 

This  upraised  and  softened  horn  once  thrown  off  is  not 
again  renewed,  and  the  whole  of  the  sensitive  frog  and 
perhaps  a  portion  of  the  sensitive  sole  is  left  uncovered. 
In  place  of  the  normal  horn,  however,  is  often  found  a 
hypertrophy  of  the  elements  of  the  keratogenous  membrane 
leading  to  huge  fungoid-looking  growths  with  a  papillo- 
matous aspect,  damp  in  appearance  and  offensive  in  smell, 
and  readily  bleeding  when  injured  (see  Fig.  134). 

The  horn  immediately  surrounding  the  lesion  is  loose 
and  non-adherent  to  the  sensitive  structures.  This  in- 
dicates, of  course,  that  the  disease  has  spread  further 
beneath  the  horny  covering  than  is  at  first  sight  apparent. 
Portions  of  this  loose  horn  removed  reveal  beneath  it  a 
caseous  fcetid  matter,  easily  removed  by  scraping  (the  per- 
verted secretion  of  the  keratogenous  membrane).  When 
this  is  carefully  scraped  away,  the  sensitive  structures 
appear  to  be  covered  with  a  thin,  smooth  membrane,  gray 
in  colour  and  almost  transparent,  while  beneath  it  may  be 
seen  the  red  appearance  of  normal  sensitive  structures. 

If  the  horn  surrounding  the  lesion  is  not  touched  with 
the  knife,  but  little  is  seen  of  the  extent  of  the  disease,  for 
that  removed  by  natural  means  is  often  very  small  in 
quantity.  To  all  intents  and  purposes  the  disease  appears 
to  be  confined  to  the  frog.  This  appearance  is  misleading, 
especially  if  the  disease  has  been  in  existence  for  some  time, 
for  it  may  have  easily  spread  to  the  whole  of  the  sole,  and 
even  to  the  greater  portions  of  the  laminae  secreting  the  wall. 

It  is,  in  fact,  not  until  the  pressure  exerted  by  the 
normal  horn  is  removed  by  its  breaking  away  that  the 
vascular  structures  of  the  keratogenous  membrane  begin 
to  swell,  and  the  perverted  secretions  to  enlarge  in  size. 
Once  the  pressure  is  removed,  however,  this  quickly  comes 
about,  and  the  characteristic  fungoid  growths  rapidly  make 
their  appearance. 

This  tendency  to  spread  is  highly  indicative  of  canker. 


312         DISEASES  OF  THE  HORSE'S  FOOT 

The  serous  matter  exuding  from  the  diseased  keratogenous 
membrane  appears,  in  fact,  to  be  highly  infective.  Once 
its  flow  is  commenced,  it  slowly,  but  surely,  invades  the 
sensitive  structures  near  it,  appearing,  as  Blaine  has  put  it, 
to  '  inoculate  '  them.  What  is  really  the  case,  of  course,  is 
not  that  the  discharge  itself  is  infective,  but  that  it  is  con- 
taminated with  infective  material. 

The  fungoid-looking  growths  to  which  we  have  before 
referred,  are  in  reality,  nothing  more  than  the  villi  of  the 
sensitive  frog  and  sole  greatly  hypertrophied  and  irregular 


Fig.  135. — Lower  Aspect  of  Cankered  Foot,  showing 
Destruction  of  Wall. 

in  shape.  At  times  the  hypertrophy  is  as  a  huge  and 
compact  enlargement  occupying  the  position  of  the  frog. 
Sometimes,  however,  it  occurs  as  numerous  elongated  and 
twisted  fibrous  bundles,  separated  from  each  other  by  deep 
clefts,  and  the  clefts  filled  with  the  offensive  cankerous 
discharge  (see  Fig.  134). 

At  a  very  advanced  stage  canker  leads  to  destruction 
of  much  of  the  horny  sole  and  frog;  or  even  parts  of  the 
wall  may  become  separated  from  the  tissues  beneath,  and 
break  away  from  the  foot  (see  Fig.  135).     At  other  times 


INFLAMMATORY  AFFECTIONS  313 

the  disease  brings  about  a  deformity  of  the  whole  of  the 
foot.  Its  longitudinal  and  transverse  diameters  become 
enormously  increased,  and  the  whole  foot  apparently 
flattened  from  above  to  below  (see  Fig.  136).  This  indi- 
cates that  not  only  has  the  horny  sole  been  entirely 
destroyed,  but  that  the  destructive  process  has  also  extended 
to  the  greater  part  of  the  lower  half  of  the  wall,  with 
a  consequent  hypertrophy  of  exposed  soft  structures,  and  a 
sinking  of  the  bony  column,  similar  to  that  which  occurs 
in  laminitis,  but  not  so  pronounced. 


Fig.  136. — Foot  with  Advanced  Canker. 

A  further  aspect  of  the  badly-cankered  foot  is  to  be  found 
in  an  apparently  enormous  increase  in  the  length  of  the 
wall.  This  we  have  seen  protruding  for  quite  5  inches 
beyond  the  plane  of  the  sole.  It  simply  indicates  that, 
in  order  to  keep  the  animal  at  work,  the  smith  has  at  every 
shoeing  spared  the  wall,  so  that  the  diseased  structures 
might  be  kept  from  contact  with  the  ground. 

As  we  have  said  before,  pain  and  other  symptoms  of 
distress  are  quite  absent.  Animals  affected  with  canker 
for  a  long  time  maintain  their  condition,  feed  well,  and 
are  quite  capable  of  performing  work  under  ordinary  con- 
ditions. 


314        DISEASES  OF  THE  HORSE'S  FOOT 

Differential  Diagnosis  and  Prognosis. — Perhaps  the  only 
disease  with  which  canker  may  be  confounded  is  thrush. 
They  should,  however,  be  easily  distinguishable.  The  dis- 
charge from  thrush  is  not  so  profuse,  and  is  thicker  and 
darker  in  colour,  while  the  loosening  of  the  horn  is  almost 
entirely  absent.  Furthermore,  thrush  shows  no  tendency 
to  spread,  and,  even  when  left  untreated,  may  remain 
confined  to  the  frog  for  months,  and  even  years.  Canker, 
on  the  other  hand,  is  slowly  progressive,  and  soon  shows 
the  characteristic  fungoid  excresences,  which  growths  are  in 
thrush  never  seen.  A  further  point  of  difference  is  dis- 
covered when  treatment  is  commenced.  Canker  is  found 
to  be  refractory  to  a  point  that  is  absolutely  disheartening, 
while  thrush,  with  careful  attention,  is  soon  got  under  hand, 
and  a  permanent  cure  effected. 

The  prognosis  must  be  guarded.  By  many  canker  has 
been  said  to  be  incurable.  This,  however,  has  been  clearly 
shown  to  be  wrong.  When  the  animal  is  young,  and  treat- 
ment may  reasonably  be  judged  to  be  economical,  then  a 
favourable  prognosis  may  be  indulged  in,  provided  the 
veterinary  surgeon  intends  to  put  into  that  treatment  a 
more  than  ordinary  amount  of  individual  care  and  atten- 
dance. Even  then,  however,  he  will  have  to  be  very  largely 
guided  by  the  condition  of  his  case.  He  should  see  that  it 
is  not  too  far  advanced,  and  that  a  great  deformity  of  the 
hoof,  or  actual  exploration,  does  not  indicate  disease  of  the 
greater  part  of  the  wall. 

Treatment. — From  what  has  gone  before,  it  will  be  seen 
that  the  eradication  of  canker  is  no  easy  task,  that  it  is, 
in  fact,  a  more  difficult  matter,  and  one  not  to  be  lightly 
undertaken.  At  the  risk  of  recapitulating  what  we  have 
said  before,  we  may  mention  here  the  two  points  which  the 
veterinarian  must  bear  in  mind.  (1)  That  there  is  no 
actual  disease  or  alteration  in  structure  of  the  deep  layers 
of  the  keratogenous  apparatus.  It  is  only  the  superficial, 
or  horn-secreting,  layer  that  concerns  us.  (2)  That  the 
disease  of  this  superficial  layer  is  infection  with  a  material 
that  may  reasonably  be  presumed  to  be  infective. 


INFLAMMATORY  AFFECTIONS  315 

Put  thus,  treatment  of  canker  would  at  first  sight  appear 
to  be  easy.  One  would  imagine  that  a  simple  and  long- 
continued  soaking  of  the  entire  foot  in  a  strong  enough 
antiseptic  would  be  all  that  was  needed.  Clinical  observa- 
tion, however,  showrs  that  this  is  not  so,  and  for  this  there 
must  be  reasons. 

The  reasons  are  these :  ( 1 )  Between  us  and  the  diseased 
layer  upon  which  our  attention  must  be  directed  is  often  a 
layer  of  normal  horn,  effectually  protecting  the  tissues 
beneath  from  any  dressing  wrhich  we  might  consider 
beneficial.  (2)  Anything  applied  with  the  object  of  de- 
stroying septic  material,  but  strong  enough,  or  caustic 
enough,  to  injure  the  membrane  upon  which  we  are  working, 
only  makes  the  case  worse.  The  superficial  layer  of  the 
keratogenous  membrane  in  which  we  have  judged  the 
disease  to  exist  is,  after  all,  but  a  delicate  structure.  When 
attacked  by  the  application  of  too  potent  a  drug  its  horn- 
secreting  layer  is  easily  destroyed,  and  thus,  although  we 
may  succeed  in  establishing  asepsis,  we  cannot  expect  at  the 
point  of  injury  a  growth  of  horn.  In  its  place  we  are 
confronted  with  large  outgrowths  of  inflammatory  fibrous 
tissue.  (3)  Shedding  of  the  diseased  horn  and  removal  of 
the  pressure  exerted  by  the  hoof  faces  us  with  hypertrophy 
of  the  exposed  villi.  The  difficulty  of  meeting  this  with  an 
adequate  and  evenly-distributed  pressure  is  well  enough 
known,  and  wre  find  in  that  a  further  reason  that  the  treat- 
ment of  canker  is  superlatively  difficult.  (4)  The  material 
on  which  the  animal  has  to  stand  is  a  distinct  bar  to  the 
maintaining  of  a  strict  asepsis. 

When  we  have  said  this,  it  is  easy  to  understand  that 
canker  is  not  to  be  successfully  met  with  any  so-called 
specific — that  it  makes  but  little  difference  what  applica- 
tion may  be  so  long  as  it  is  antiseptic,  and  is  used  by  a  man 
thoroughly  conversant  with  the  difficulties  he  has  to  contend 
with,  and  with  his  mind  firmly  set  upon  surmounting  them. 

With  this  point  established,  we  will  not  devote  more  of 
our  space  to  a  consideration  of  the  various  dressings  that 
have  at  different  times  been  highly  advocated  in  the  treat- 


316         DISEASES  OF  THE  HORSE'S  FOOT 

ment  of  the  disease.  It  is  interesting,  however,  to  note  that 
intensely  irritating  and  caustic  applications  have  been 
greatly  in  favour.  Nitric  acid,  sulphuric  acid  (either  alone 
or  its  action  reduced  by  the  addition  of  alcohol,  oil,  or  tur- 
pentine), arsenic,  butter  of  antimony,  creasote,  chromic 
acid,  carbolic  acid,  arsenite  of  soda,  and  the  actual  cautery, 
have  all  been  used. 

Without  dwelling  further  on  that,  we  may  say  at  once 
that  a  correct  treatment  consists  in  (1)  the  removal  of  all 
horn  overlying  infected  portions  of  the  keratogenous  mem- 
brane, (2)  the  application  of  an  antiseptic  not  too  power- 
fully caustic  in  its  action,  (3)  frequent  changes  of  the  dress- 
ings in  order  to  insure  a  maintenance  of  antisepsis,  and 
(4)  the  application  of  an  adequate  pressure  to  the  exposed 
soft  structures.     Thus  combated,  canker  is  curable. 

The  man  who,  at  the  expense  of  much  time  and  trouble, 
has  demonstrated  the  truth  of  these  axioms  is  Mr.  Malcolm, 
of  Birmingham.  The  determination  with  which  he  clung 
to  his  point  that  canker  was,  with  correct  treatment,  in 
every  case  curable,  was  some  years  ago  provocative  of  much 
discussion  in  veterinary  circles.  That  he  was  successful  in 
proving  his  contention  is  more  to  our  point  here.  It  is  his 
method  of  treatment,  therefore,  that  we  shall  give,  and  this 
we  shall  do  by  liberal  extracts  from  Mr.  Malcolm's  own 
writings. 

!  On  the  first  occasion  of  operating  upon  and  dressing 
the  cankered  foot,  it  is  usually  necessary  to  cast  the  horse, 
and  this  may  have  to  be  done  at  intervals  for  a  second  or 
even  third  time;  but  in  most  cases  once  is  sufficient,  sub- 
sequent dressing  being  usually  accomplished  without  much 
difficulty,  frequently  even  without  the  aid  of  a  twitch. 
After  the  horse  has  been  secured,  the  drawing-knife  is  first 
employed ;  and  if  the  frog  alone  is  affected,  it  is  unneces- 
sary even  to  pare  the  sole,  the  removal  of  all  frog  horn  not 
intimately  adherent  to  its  secreting  surface  being  all  that  is 
required.  But  if  both  sole  and  frog  be  involved,  the  whole 
of  the  sound  horn  should  be  first  thinned  until  it  springs 
under  the  thumb,  and  then,  using  a  sharp  knife,  every  par- 


INFLAMMATORY  AFFECTIONS  317 

tide  of  diseased  horn  must  be  carefully  removed  from  both 
sole  and  frog,  a  process  much  more  easily,  and  with  far 
greater  certainty,  secured  by  the  previous  thinning  of  the 
horn. 

1  The  removal  of  diseased  horn  should  always  commence 
at  the  most  dependent  part  of  the  foot,  so  that  any  haemor- 
rhage produced  may  be  below  the  parts  still  to  be  operated 
on,  a  matter  of  considerable  moment  for  effective  treatment. 
But  with  due  care  there  will  be  little  haemorrhage,  as, 
except  in  the  initial  stage,  there  is  no  real  union  between  the 
diseased  horn  and  the  diseased  vascular  secreting  surface. 

1  After  all  apparently  diseased  horn  has  been  removed  by 
the  knife,  any  still  remaining  should  be  at  once  destroyed 
by  the  actual  cautery,  by  which  it  can  be  identified.  All 
the  diseased  secreting  surface  should  be  carefully  scraped 
with  a  thin  hot  iron*  fungoid  growths  excised  and  cauter- 
ized, and,  indeed,  every  particle  of  cankered  tissue  should, 
if  possible,  be  eradicated.  In  securing  this  more  reliance 
can  be  placed  on  the  actual  cautery  than  on  any  other, 
whether  liquid  or  solid :  it  is  more  under  control  in  applica- 
tion, more  decisive  in  effect,  and  its  results  can  be  antici- 
pated with  a  far  greater  certainty.  Moreover,  its  aid  in 
diagnosis  is  of  immense  value ;  applied  to  the  thinned  horn 
or  secreting  surface  it  unmistakably  demonstrates  the  pre- 
sence or  absence  of  canker.  Healthy  tissue  chars  black; 
cankered  tissue,  on  the  contrary,  bubbles  up  white  under 
the  hot  iron,  and  presents  an  appearance  not  unlike  roasted 
cheese. 

'  Although  this  test  is  certain  for  horn  thinned  to  the 
quick,  it  is  not  to  be  relied  upon  with  thick  horn,  the  out- 
side of  which  may  be  practically  healthy  and  char  black, 
while  its  underlying  surface  may  be  cankered.  With  this 
exception  the  test  is  an  infallible  one,  as  by  it  the  demarca- 
tion between  cankered  and  healthy  tissue  can  be  clearly 
traced,  and  as  a  result  we  can  with  equal  confidence  radi- 
cally remove*  all  cankered  tissue,  and  conserve  all  healthy. 

*  The  words  in  italics  are  alterations  in  the  original  article  made 
by  Mr.  Malcolm  in  a  private  letter  to  the  author   (H.  C.  R.)- 


318        DISEASES  OF  THE  HORSE'S  FOOT 

As  the  object  of  that  abominably  cruel  and  barbarous 
operation  of  stripping  the  sole  is  the  exposure  of  all  canker, 
and  as  this  can  be  done  with  equal  certainty  with  the  aid  of 
the  hot  iron,  there  can  be  no  necessity  for  performing  it. 
The  pain  of  cauterizing  cankered  tissue,  which  is  a  neces- 
sary operation,  is  infinitesimal  (canker  largely  destroying 
sensation),  compared  with  the  pain  produced  in  the  totally 
unnecessary  process  of  tearing  healthy  horn  from  a  highly 
sensitive  tissue. 

'  Having  by  means  of  the  knife  and  cautery  removed 
every  known  particle  of  disease,  the  next  procedure  is  to 
pack  the  surface  of  the  sole  and  frog  thus  exposed  with  a 
mild  dressing,  such  as  vaseline ;  but  if  the  cankered  surface 
has  not  been  efficiently  scraped,  then  there  is  required  a 
more*  powerful  astringent  or  caustic  dressing,  which  may 
vary  considerably  according  to  the  individual  fancy.  A 
great  favourite  of  mine  consists  of  equal  parts  of  sulphates 
of  copper,  iron,  and  zinc,  mixed  with  strong  carbolic  acid, 
a  very  little  vaseline  being  added  to  give  the  mass  cohesion. 
The  dressing,  covered  by  a  pledget  of  tow,  is  held  in  posi- 
tion by  a  shoe  with  an  iron  or  leather  sole,  and  the  dressing 
and  tow  together  should  be  of  sufficient  bulk  to  produce 
slight  pressure  on  the  sole  when  the  nails  of  the  shoe  are 
drawn  up.  This  insures  contact  between  the  dressing  and 
the  exposed  surface,  as  well  as  any  benefit  derivable  from 
pressure. 

1  The  dressing  of  the  foot  and  nailing  of  the  shoe  can 
usually  be  more  expeditiously  performed  when  the  horse  is 
on  his  feet  than  when  prone.  If  only  the  frog,  or  the  frog 
and  a  small  part  of  the  sole,  be  involved,  the  horse  should 
be  kept  at  work,  but  if  a  large  part  or  the  whole  of  the  sole 
a  few  days'  rest  may  be  necessary ;  but  as  soon  as  the  con- 
dition of  the  foot  will  allow,  work  should  be  resumed,  and 
it  is  simply  marvellous  how  sound  a  horse  will  walk  while 
minus  the  greater  part  of  his  sole  from  canker. 

'  On  the   second   day  following  the   shoe   should  be  re- 

*  The  words  in  italics  are  alterations  in  the  original  article  made 
by  Mr.  Malcolm  in  a  private  letter  to  the  author  (H.  C.  R.). 


INFLAMMATORY   AFFECTIONS  319 

moved,  and  the  foot  redressed.  To  effect  this  it  is  necessary 
to  recast  the  horse.  Commencing  at  the  edge  of  the  sound 
horn,  at  the  most  dependent  part  of  the  foot,  all  new  horn, 
no  matter  what  its  condition,  must  be  pared  to  the  quick, 
especial  care  being  taken  to  effectually  remove  any  linger- 
ing disease.  Want  of  success  is  frequently  attributable  to 
neglect  of  this  precaution.  A  small  particle  of  canker 
remains  undetected,  forms  a  new  centre  of  infection,  and 
just  when  success  is  anticipated,  much  to  your  chagrin  you 
have  to  deal  with  a  fresh  outbreak  of  canker,  instead  of  a 
rapidly-healing  foot.  Parenthetically,  I  may  here  remark 
that  the  amount  of  more  or  less  imperfect  new  horn  pro- 
duced by  a  cankered  surface  after  an  effective  but  not  too 
destructive  cauterization  is  almost  incredible,  and  one  can- 
not fail  to  be  struck  with  the  very  active  proliferation  here 
compared  with  the  meagre  production  of  new  horn  by  the 
healthy  surface. 

'  After  all  disease  has  been  excised,  carefully  clean  the 
foot  with  waste,  thoroughly  protect  any  raw  surface  result- 
ing from  overcauterization  by  some  mild  agent,  such  as  a 
saturated  calomel  ointment,  reapply  an  astringent  dressing 
over  the  whole  affected  surface,  and  nail  on  the  shoe.  This 
method  of  procedure  should  now  be  thoroughly  carried  out 
daily  for  a  time,  and  as  it  is  proceeded  with  a  successful 
issue  soon  becomes  assured  in  nearly  every  case.  Where, 
in  spite  of  these  efforts,  the  disease  still  persists,  depend 
upon  it  the  fault  is  with  the  operator,  who  has  failed  to 
eradicate  some  centre  of  infection.  Under  these  circum- 
stances it  may  be  necessary  to  recast  the  patient,  repare 
the  foot,  and  by  the  aid  of  eye,  knife,  and  cautery,  en- 
deavour to  find  the  cause,  and  having  found  it,  which  can 
invariably  be  done,  remove  it.  The  usual  treatment  will 
then  speedily  become  successful.  As  the  case  proceeds 
dressing  every  other  day  will  soon  be  sufficient,  then  twice 
a  week,  and  finally,  once  a  week  until  sufficiently  cured. 

'  During  this  healing  process,  and  after  the  complete 
eradication  of  canker  it  may  be  again  repeated,  no  agent 
seems  to  have  a  more  beneficial  effect  than  calomel,  and  for 


320  DISEASES  OF  THE  HORSE'S  FOOT 

this  purpose  it  is  best  used  as  a  dry  powder.  Under  this 
dressing  any  remaining  spot  of  canker  is  readily  detected 
by  the  wet  condition  of  the  calomel  when  the  shoe  is 
removed  the  next  day.  In  dealing  with  such  a  spot,  a  very 
good  plan,  after  all  apparently  diseased  tissue  has  been 
excised,  is  to  touch  the  cankered  part  with  solid  nitrate  of 
silver,  or  a  feather  dipped  in  one  of  the  strong  mineral 
acids,  and  then  reapply  calomel  over  the  surface.  The 
result  of  this  treatment  is  frequently  very  gratifying. 

'  In  successful  treatment  the  shoe  must  be  removed  each 
time — an  adjustable  plate  will  not  do,  as  no  man  can 
thoroughly  pare  and  examine  a  foot  with  the  shoe  on,  and 
imperfect  dressings  are  worse  than  useless.  Indeed,  it  is 
better  not  to  pare  or  thin  the  horn  at  all,  than  to  imper- 
fectly pare,  since  canker,  if  undestroyed,  develops  far  more 
rapidly  under  thin  horn  than  under  thick. 

'  In  conclusion,  I  would  again  urge  the  necessity,  at  the 
very  first  operation,  when  the  horse  is  down,  of  removing 
every  single  particle  of  the  diseased  tissue,  either  by  excision 
or  effectual  cauterization,  but  at  the  same  time  taking  very 
great  care  to  guard  against  the  latter  being  too  destructive. 
The  cautery  should  be  laid  aside  as  soon  as  the  tissue 
cauterized  ceases  to  burn  white.  The  moment  at  which  the 
canker  has  thus  been  eradicted  without  destroying  sound 
tissue  is  indicated  by  the  appearance  of  healthy  horn,  by 
the  intimate  union  of  that  with  the  secreting  surface,  and 
by  the  healthy  aspect  of  the  exuded  blood  when  paring  has 
been  carried  to  the  quick. 

■  Should  subjacent  healthy  structures  be  destroyed  during 
the  process,  that  is  shown  by  the  production  of  a  raw  sore, 
or  of  a  sore  to  which  a  "sit-fast,"  coextensive  to  the  injury, 
is  firmly  attached.  This  seriously  retards  recovery.  The 
secreting  surface  having  been  destroyed,  no  new  horn  can 
be  produced  directly  from  the  part,  and  a  new  secreting 
surface  and  new  horn  have  now  to  grow  inwards  from  the 
surrounding  undestroyed  tissue,  and  that  is  a  slow  process. 
At  the  same  time,  on  the  principle  of  choosing  the  least  of 
two  evils,  practical  experience  teaches  that  it  is  better  to 


INFLAMMATORY  AFFECTIONS  321 

produce  a  small  sore  or  a  "  sit-fast  "  than  to  leave  a  part  of 
the  canker  undetected ;  but,  on  the  other  hand,  it  is  better 
to  leave  a  small  part  of  canker  undetected,  which  can  be 
recognized  and  removed  at  the  next  examination,  than  to 
cause  a  large  slough.  The  object  of  the  skilful  surgeon  is, 
naturally,  to  avoid  both  extremes ;  and  if  trouble  be  taken 
to  carry  out  the  procedure  described,  there  need  be  no  fear 
of  the  result.'* 

Treated  in  this  way,  the  horse  with  cankered  feet  may  be 
usually  kept  at  work  during  the  whole  time  that  treatment 
is  carried  out,  and  a  cure  is  obtainable  in  periods  varying 
from  six  weeks  to  six  or  even  twelve  months. 

The  same  essentials  in  treatment — namely,  removal  of 
diseased  horn,  antiseptic  dressings,  and  pressure — are  in- 
sisted on  by  other  writers.  Bermbach,*}"  in  1888,  treats 
canker  as  follows:  The  horse  having  been  cast,  the  under- 
mined hoof-horn  is  removed  with  the  knife,  and  the  hyper- 
trophied  sensitive  structures,  if  necessary,  reduced  in  the 
same  manner.  The  chief  difficulty  in  removing  the  latter 
is  experienced  in  the  lateral  lacunae  of  the  frog,  where  it  is 
most  conveniently  scraped  away  with  a  spoon  or  sharp 
curette.  Professor  Hoffmann  and  Imminger  also  operate  in 
the  same  way,  applying  an  Esmarch's  haemostatic  bandage, 
and  using  the  knife  and  curette  freely. $ 

Haemorrhage  is  afterwards  arrested,  and  a  dressing  of 
perchloride  of  mercury  (a  solution,  }  per  cent.,  in  equal 
parts  of  alcohol  and  water)  applied.  The  after-dressings 
succeeding  best  are  those  of  slightly  caustic  and  astringent 
agents,  preferably  in  the  form  of  a  powder,  and  held  in 
position  by  carbol-jute  pads  and  linen  bandages  applied 
with  a  certain  amount  of  pressure. 

The  same  author  draws  attention  to  the  fact  that  caustic 
agents  such  as  nitrate  of  lead,  chloride  of  zinc,  etc.,  act  too 
powerfully  if  the  bleeding  has  been  arrested  and  the  wound 

*  Journal  of  Comparative  Pathology  and  Therapeutics,  vol.  iv., 
p.  24. 

t  Ibid.,  vol.  ii.,  p.  68. 
+   Veterinary  Journal,  vol.  xxxv.,    p.  433. 


322        DISEASES  OF  THE  HORSE'S  FOOT 

disinfected.  They  then  form  a  thick  crust,  under  which 
profuse  suppuration  takes  place.  The  same  agents  are  like- 
wise contra-indicated  when  haemorrhage  is  still  present.  In 
this  latter  case  they  combine  with  the  blood  to  form  metallic 
albuminates,  which  lie  as  an  impenetrable  layer  on  the 
surface  of  the  wound,  and  so  hinder  the  action  of  drugs 
on  the  tissue  below 

During  his  after-treatment,  Brembach  advocates  removal 
of  the  dressings  every  second  day,  all  cheesy  material  to  be 
scraped  away  with  the  knife,  and  the  sublimate  lotion  to  be 
used  again.  He  also  insists  on  the  animal  being  kept 
standing  in  a  dry  stable — nothing  but  a  stone  pavement 
kept  clean — and  put  to  regular  work  in  a  plate  shoe  after 
the  first  or  second  week.  Cure  of  advanced  cases  is  said  to 
be  obtainable  in  from  four  to  six  weeks. 

As  illustrative  of  the  value  of  pressure  in  the  treatment 
of  canker,  we  may  also  draw  attention  to  a  treatment  advo- 
cated by  Lieutenant  Rose.*  This  observer  holds  that  ade- 
quate pressure  is  unobtainable  by  packing  the  foot,  and,  to 
obtain  it,  removes  the  wall  from  heel  to  heel,  much  after 
the  manner  of  preparing  the  foot  for  the  Charlier  shoe,  so 
that  the  whole  of  the  weight  is  taken  by  the  sole  and  the 
frog.  Tar  and  tow  is  then  lightly  applied,  the  foot  placed 
in  a  boot,  and  the  patient  turned  into  a  loose-box.  The 
dressing  is  repeated  at  intervals  of  four  or  five  days  until 
the  animal  is  cured. 

Those  who  have  followed  this  method  of  treatment  have 
modified  it  by  actually  shoeing  the  animal  Charlier  fashion, 
and  keeping  him  at  work,  attention,  of  course,  being  at  the 
same  time  given  to  a  proper  antiseptic  dressing. 

Reported  Cases. — 1.  (Malcolm's  Treatmentf ).  The  sub- 
ject was  a  five-year  old  horse  belonging  to  a  client  of  Mr. 
Olver's,  of  Tamworth.  The  case  was  an  exceptionally  bad 
one,  for  not  only  was  the  whole  of  the  frog  and  sole  of  the 
near  hind-foot   cankered,   but   the   disease   on   the   outside 

*  Veterinary  Record,  vol.  xi.,  p.  435. 
t  Journal  of  of  Comparative  Pathology  and  Therapeutics,  vol.  v., 
P.  48. 


INFLAMMATORY  AFFECTIONS  323 

quarter  extended  to  within  |  inch  of  the  coronet,  and  on 
the  inside  quarter  to  within  2  inches  of  it.  As  the  owner, 
a  farmer,  had  not  proper  convenience  for  Mr.  Olver  to  treat 
the  case,  the  latter  asked  me,  while  visiting  him,  if  I  would 
care  to  undertake  the  treatment,  saying,  at  the  time  it  would 
be  a  very  good  test-case,  as  the  disease  was  so  far  advanced. 
I  readily  agreed,  and,  after  the  necessary  arrangements, 
had  the  horse  removed  to  Birmingham  on  July  2.  In  this 
case  it  wras  found  necessary  to  cast  the  animal  and  cauterize 
the  foot  a  second  time  before  a  healthy  granulating  surface 
was  secured;  but  after  this  the  progress  towards  recovery 
was  uninterrupted,  although  necessarily  slow,  on  account 
of  the  large  amount  of  new  secreting  surface  which  had  to 
be  formed. 

The  horse  was  finally  discharged,  after  inspection  by 
Mr.  Olver,  absolutely  cured  and  free  from  canker,  on 
January  7. 

The  illustration  (Fig.  135,  p.  312)  is  from  a  photograph, 
and  it  gives  a  somewhat  imperfect  representation  of  the 
state  of  the  foot  two  months  after  it  came  under  my 
care. 

2.  (Rose's  Treatment.*)  This  was  a  bad  case  of  canker, 
which  had  been  for  two  or  three  months  treated  in  the 
ordinary  manner,  with  but  little  sign  of  ultimate  success. 
Commenced  in  June  and  carried  on  until  the  end  of  Sep- 
tember, the  ordinary  treatment  consisted  in  burning  down 
the  fungus  growth  with  the  hot  iron,  and  dressing  with 
copper  sulphate,  zinc  sulphate,  and  boracic  acid.  The 
cauterization  was  repeated  every  five  days. 

The  treatment  of  Lieutenant  Rose  was  commenced  at 
about  the  end  of  September,  at  which  date  the  disease 
extended  from  the  toe  on  one  side  of  the  foot  right  back 
to  the  heel,  involving  the  sole,  half  of  the  frog,  and  the 
bulb  of  the  heel.  One  week  after  treatment  the  diseased 
surface  was  drier,  and  granulations  were  more  healthy. 
At  the  expiration  of  a  fortnight  the  new  horn  had  com- 
menced to  grow  from  the  wall,  and  also   from  the   frog. 

*  Veterinary  Record,  vol.  xi.,  p.  435. 


324        DISEASES  OF  THE  HORSE'S  FOOT 

right  round  the  diseased  surface,  the  diseased  part  of  the 
bulb  of  the  heel  being  divided  from  the  sole  by  new  horn. 

Three  to  four  weeks  later  the  diseased  surface  was  gradu- 
ally getting  smaller,  while  in  about  six  weeks  it  was  quite 
healed  up,  the  last  place  to  heal  being  a  strip  outside  the 
bar,  between  it  and  the  wall,  and  a  smaller  spot  on  the 
bulb  of  the  heel.  These  healed  up  simultaneously,  and 
left  the  animal  sound. 

3.  (Treatment  by  Pressure,  H.  Leeney*).  I  was  consulted 
in  the  early  part  of  last  summer,  before  the  dry  weather 
had  begun,  as  to  a  farm-horse  with  canker  in  three  feet. 
Her  shoes  were  in  the  'disgruntle'  condition  we  so  often  find 
on  farms,  that,  to  give  her  a  level  bearing  until  I  should 
call  another  day  with  a  farrier  to  help  me  to  pack  the  foot  up 
in  the  old-fashioned  way,  I  had  the  remaining  shoes  pulled 
off.  The  case  somehow  dropped  out  of  my  list,  and  I 
neglected  to  call,  until  asked  one  day  to  see  something  else. 

I  then  found  that,  under  a  pressure  of  work,  the  animal 
had  been  used  in  the  shafts  of  a  farm-cart  on  tolerably  level 
ground,  and  when  the  dry  weather  had  already  set  in.  There 
was  a  distinct  improvement  in  all  the  diseased  feet,  and  as 
she  was  badly  wanted  I  contented  myself  with  rasping  off 
some  broken  crust,  and  supplied  some  caustic  dressing  for 
use  at  night.  Without  shoes  she  worked  continuously  on  the 
dry  and  hard  meadow-land  for  several  weeks,  and  was 
practically  cured  in  something  less  than  three  months.  My 
astringent  or  caustic  lotion  may  have  had  something  to  do 
with  the  cure  of  the  deep-seated  parts,  but  the  bare  recital 
of  the  case  should  be  sufficient  to  show  that  it  is  all  a 
question  of  bearing,  or  nearly  so. 

7.     Specific  Coronitis. 

Definition. — In  describing  this  condition  under  the  above 
heading,  we  are  following  the  lead  of  Mr.  Malcolm.  We 
may  define  it  as  a  chronic  inflammatory  condition  of  the 
keratogenous   membrane,   usually   confined   to  that   of   the 

*  Veterinary  Record,  vol.  xi.,  p.  447. 


INFLAMMATORY  AFFECTIONS  325 

coronary  cushion,  the  ergots  and  the  chestnuts,  but  some- 
times extending  to  that  of  the  frog  and  the  sole,  characterized 
by  a  malsecretion  of  the  affected  membrane  similar  to  that 
observed  in  canker. 

Causes. — The  cause  which  we  have  indicated  for  canker — 
namely,  a  local  specific  one,  is  in  all  probability  the  one 
operating  here.  Apparently  there  is  a  variance  of  opinion 
as  to  whether  the  condition  is  actually  canker  or  not.  We 
think,  however,  that  the  character  of  the  secretion  of  the 
affected  membranes,  the  appearance  of  the  growths,  the 
manner  in  which  they  react  to  the  hot  iron,  the  comparative 
absence  of  pain,  and  other  points  of  similarity,  point  to  the 

i  fact  that  the  two  conditions  are  actually  identical.  In  other 
words,  the  cause  is  precisely  the  same,  and  the  only  point  of 
difference  is  the  alteration  in  the  point  of  attack. 

Symptoms. — Like  canker,  the  disease  is  insidious  in  onset. 
In  precisely  similar  manner  the  horn,  and  in  this  case  the 
skin  of  the  coronet,  is  underrun.     Later  there  is  the  partial 

|  shedding  and  Assuring  of  the  undermined  horn  and  the 
exuding  of  the  characteristic  discharge — in  this  case  not  so 
watery  as  that  of  canker.     The  caseous  material  of  canker 

■  is  also  present,  as  is  a  disposition  to  hypertrophy  of  the 
exposed  sensitive  structures.     What  horn  is  left  becomes 

i  rough  and  irregularly  fissured,  and  has  been  likened  by 
some  observers  to  deeply-wrinkled  bark  of  an  old  tree.     A 

-  peculiar  characteristic  of  this  condition  is  the  state  of  the 
ergots  and  chestnuts.  Here  the  keratogenous  membrane 
participates  in  the  diseased  process,  and  their  horn  becomes 
dry  and  brittle,  and  readily  splits  into  small  fibrous  bundles 
very  similar  to  the  fibroid  growth  described  in  canker. 
These  excrescences  are  easily  separated  from  the  sensitive 
structures  beneath,  and  the  exposed  surface  is  seen  to  be 
more  or  less  moist, or  even  exhibiting  a  slight  oozing  of  blood. 
Again,  as  in  canker,  the  deeper  layers  of  the  sensitive 
structures  appear  to  be  normal,  the  horn-secreting  layers 
being  the  only  ones  affected.  According  to  Malcolm,  the 
disease  is  in  its  nature  equally  as  inveterate  as  canker,  but 
it  is  easier  to  treat,  on  account  of  its  more  exposed  position 


326        DISEASES  OF  THE  HORSE'S  FOOT 

Treatment. — This  is  exactly  that  as  described  for  canker. 

Recorded  Case. — The  subject  of  this  case  was  a  young 
black  cart  gelding.  The  disease  is  reported  as  having  begun 
as  thrush,  and  then  extended  to  the  coronet.  When  I  saw 
him  he  had  been  in  a  similar  condition  to  that  depicted  in 
Fig.  137  for,  it  was  said,  two  or  three  months,  the  driver 
of  the  horse  meanwhile  endeavouring  to  effect  a  cure  by 
some  potent  drug  of  his  own.  The  animal  was  in  good 
condition,  but  walked  with  difficulty  owing  to  the  pain.  The 
coronary  bands  were  swollen  to  two  or  three  times  their 


Fig.   137.— Specific  Coronitis  of  all  Four  Feet. 


natural  size,  and  this  caused  the  hair  immediately  above  to 
curl  upwards.  Just  below  the  coronary  bands  there  was 
a  line  of  separation  between  them  and  the  wall.  They 
themselves  were  covered  with  the  cheesy  substance  typical 
of  canker,  and  they  bled  on  friction.  Down  the  wall  of  the 
off  fore-foot  some  blood  had  trickled,  which  may  be  seen  in 
Fig.  138.  The  frogs  of  all  four  feet  bulged  backwards,  and 
were  badly  affected.  The  soles  were  covered  with  normal 
horn,  but  I  did  not  resort  to  paring  to  see  if  they  were 
affected.     One  very  curious  feature  about  the  case  was  the 


INFLAMMATORY    AFFECTIONS 


327 


fact  that  all  the  callosities  (ergots  and  chestnuts)  seemed  to 
participate  in  the  morbid  process,  and  they  too,  were  covered 
with  a  thin  layer  of  soft  cheesy  horn.     The  animal  used  to 


Fig.    138. — Off    Fore-foot    affected    with    Specific    Coronitis. 

bite  at  his  coronets  and  also  the  callosities  above  the  knees 
and  hocks  until  they  bled,  which  they  did  quite  easily.  The 
owner  would  not  go  to  the  expense  of  having  him  treated, 
so  he  was  destroved.* 


*  Henry  Taylor  Veterinary  Record,  vol.  xvii.,  p.  311. 


CHAPTER  X 

DISEASES  OF  THE  LATERAL  CARTILAGES 

A.    WOUNDS  OF  THE  CARTILAGES. 

To  a  consideration  of  this  we  shall  devote  but  little  space. 
It  is  sufficient  to  say  that  any  wound  in  the  region  of  the 
coronet  should  always  be  given  the  most  careful  attention. 
More  particularly  should  this  be  so  when  it  is  ascertained 
that  the  wound  has  involved  one  of  the  lateral  cartilages. 
Wounds  of  non-vascular  bodies  such  as  these  are  always 
slow  to  heal,  and,  by  reason  of  their  slowness,  invite  septic 
infection.  In  many  cases,  in  fact,  it  happens  that  they  do 
not  heal  at  all.  Instead,  the  injured  part  becomes  necrotic, 
is  unable  to  cast  itself  off,  and  remains  as  a  centre  of 
infection  in  the  depths  of  the  wound,  thus  constituting  what 
is  known  as  a  quittor. 

Apart  from  this,  it  will  be  remembered  that  the  internal 
face  of  the  cartilage  is  in  intimate  contact  with  the  pedal 
articulation,  especially  anteriorly.  Wounds  in  this  situation 
are,  therefore,  likely  to  penetrate  the  joint,  giving  us  as 
a  complication  of  the  injury  the  conditions  of  synovitis  and 
arthritis. 

Immediately  a  wound  is  inflicted  in  this  position,  attempts 
should  be  made  to  insure  thorough  asepsis  of  the  part. 
When  possible,  by  far  the  better  way  of  accomplishing  this 
will  be  to  wholly  immerse  the  foot  in  a  tub  of  cold  antiseptic 
solution,  and  keep  it  there  for  an  hour  three  times  daily. 
During  the  times  the  foot  is  out  of  the  solution  the  wound 
should  be  protected  with  a  pad  of  carbolized  tow  or  other 

328 


DISEASES  OF  THE  LATERAL  CARTILAGES     329 

suitable  dressing,  and  wrapped  in  a  linen  bandage  or  clean 
bag.  If  unable  to  use  the  bath,  then  antiseptic  solutions  of 
more  than  moderate  strength  should  be  freely  applied  to  the 
wound  and  the  adjacent  parts,  a  carbolized  or  other  anti- 
septic pad  placed  over  it,  and  the  bandage  adjusted  as  before. 
Repeated  injuries  to  the  cartilages,  even  if  not  attended 
with  an  actual  wound,  are  apt  to  bring  about  their  ossifica- 
tion and  end  in  the  formation  of  side-bones. 


B.    QUITTOR. 

Definition. — A  fistulous  wound  of  the  foot,  usually  opening 
at  the  coronet,  and  variously  complicated  according  to  the 
structures  invaded  by  its  contained  pus.  For  the  reason 
that  quittor  is  in  every-day  veterinary  nomenclature  usually 
associated  with  necrosis  or  other  abnormal  condition  of  the 
lateral  cartilage,  we  include  its  description  in  this  chapter. 

Classification. — It  has  been  customary  with  Continental 
authors  to  classify  quittor  according  to  the  extent  and  posi- 
tion of  the  diseased  process.    There  were  thus  distinguished  : 

(a)  The  Simple  or  Cutaneous  Quittor,  in  which  had  oc- 
curred nothing  more  than  necrosis  of  a  portion  of  the 
coronary  skin  and  the  structures  immediately  underlying  it — 
that  is,  the  superficial  portion  of  the  coronary  cushion. 

(b)  The  Tendinous  Quittor,  in  which  not  only  the  imme- 
diately subcutaneous  tissues  were  attacked,  but  also  portions 
of  tendon  and  of  ligament. 

(c)  The  Sub-horny  Quittor,  in  which  the  diseased  process 
had  invaded  the  deeper  portions  of  the  coronary  cushion, 
and  continued  a  downward  course  until  the  laminal  tissue 
below  the  upper  margin  of  the  wall  was  involved,  or  any 
other  case,  no  matter  what  the  starting-point,  in  which  pus 
existed  within  the  horny  box  and  was  discharging  itself  by 
a  fistulous  opening. 

(d)  The  Cartilaginous  Quittor,  in  which  a  portion  of  the 
lateral  cartilage  had  become  attached  and  rendered  necrotic. 

We  believe  that — in  this  country,  at  any  rate — the  word 
'  quittor  '  is  usually  held  to  indicate  one  or  other  of  the  two 


330  DISEASES  OF  THE  HORSE'S  FOOT 

latter  conditions,  and  probably  the  last  of  these;  and  that 
the  two  first  are  held  of  small  account,  or  hardly  of  sufficient 
gravity  to  allow  of  the  word  '  quittor  '  being  applied  to  them. 
In  fact,  by  defining  quittor  as  a  '  fistula.'  or  little  pipe,  we 
have  ourselves  already  indirectly  restricted  the  use  of  the 
word  to  the  two  latter  conditions,  for  in  those  varieties 
known  as  Simple  or  Cutaneous  and  Tendinous,  the  wound 
is  generally  broad  and  open,  or,  at  any  rate,  superficial,  and 
can  scarcely  be  strictly  described  as  '  fistulous.'  In  the  two 
latter,  however,  a  true  fistula  exists.  These,  however,  have 
only  one  essential  difference,  and  that  consists  simply  in 
the  position  of  the  lesion  and  the  structures  it  has  attacked. 
In  the  main  the  symptoms  will  be  the  same,  the  disease  in 
each  case  about  equally  serious,  and  in  each  the  same 
essentials  of  treatment  will  have  to  be  regarded. 

In  our  opinion,  therefore,  a  lengthy  classification  serves^ 
no  useful  end,  and  we  think  matters  will  be  simplified  by 
considering  quittor  under  two  headings  only — namely, 
'  Simple  or  Cutaneous  '  and  '  Sub-horny,'  and  discussing 
the  other  varieties  as  simply  complications  of  either  of 
these  two. 

1.     Simple  or  Cutaneous  Quittor. 

Definition. — This  condition  is  simply  a  sloughing  of  a 
portion  of  the  skin  of  the  coronet,  together  with  a  portion 
of  the  immediately  underlying  soft  structures. 

Causes. — This  form  of  quittor  has  its  origin  more  often 
than  not  in  contusions,  punctures,  or  wounds  of  the  region 
severe  enough  to  cause  death  of  a  small  portion  of  the 
tissues.  In  this  case  the  low  vitality  of  the  parts  does  not 
allow  of  the  dead  portion  being  removed  piecemeal  by  a 
process  of  phagacytosis,  as  is  usually  the  case  with  similar 
injuries  elsewhere.  Instead,  the  tissues  around,  aided  by  a 
process  of  suppuration,  cast  the  offending  portion  off  as  a 
slough.  It  is  the  wound  remaining  after  the  slough  which 
we  may  really  regard  as  a  quittor.  In  this  connection  may 
be  considered  as  causes  blows  from  falling  shafts,  self- 
inflicted  treads,  or  treads  from  other  horses,  overreach,  etc. 


DISEASES  OF  THE  LATERAL  CARTILAGES    331 

On  the  other  hand,  simple  or  cutaneous  quittor  may 
occur  without  ascertainable  cause.  In  this  case  we  can 
only  explain  its  appearance,  as  we  did  that  of  simple 
coronitis  (see  p.  231),  by  attributing  it  to  septic  infection 
through  a  wound  or  a  blow  that  is  able  to  inoculate  the 
skin,  yet  which  is  insufficient  to  cause  pain,  or  in  any  other 
way  attract  the  attendant's  notice.  Meanwhile,  the  spot  of 
infection  thus  started  spreads,  and  the  end  result  is  an 
abscess  in  the  coronary  region,  again  accompanied  with 
necrosis  and  sloughing  of  more  or  less  skin  and  other 
tissue,  which  terminates  by  discharging  its  contents  and 
leaving  behind  a  wound  which  again  constitutes  a  cutaneous 
quittor.  Thus,  as  with  simple  coronitis,  anything  lowering 
the  vitality  of  the  parts,  and  so  favouring  infection  of  the 
skin,  may  bring  about  a  quittor.  Walking  through  much 
water  in  the  winter  months,  through  the  dirt  and  mud 
of  our  streets,  through  melting  ice  and  snowr,  or  through 
anything  in  the  nature  of  a  chemical  irritant,  may  be  looked 
upon  as  a  cause. 

Symptoms. — Whether  commencing  from  an  ascertainable 
injury,  or  beginning  at  first  unnoticed,  cutaneous  quittor 
is  characterized  sooner  or  later  by  the  appearance  of  an 
inflammatory  swelling,  usually  confined  to  the  seat  of  injury. 
Heat  and  tenderness  are  present,  and  the  animal  is  lame. 

Later  the  inflammatory  swelling  becomes  more  profuse, 
the  animal  is  fevered,  and  the  symptoms  of  lameness  in- 
creased. Poulticing  is  at  this  stage  perhaps  resorted  to. 
By  its  means  the  process  of  suppuration  is  aided,  and  the 
swelling  (at  first  tense  and  hard)  either  becomes  gradually 
softened,  its  contents  discharged,  and  a  simple  abscess 
cavity  left  behind,  or  the  suppuration  runs  immediately 
round  the  necrosed  structures,  and  casts  them  of!  bodily  as 
a  slough.  This  latter  condition  is  always  manifested,  where 
the  hair  does  not  hide  it,  by  the  colour  of  the  skin.  At 
first  this  is  only  red  in  colour — the  angry  red  of  an  inflamed 
spot.  As  its  intention  to  slough  away  becomes  evident,  the 
red  gradually  gives  way  to  a  gray,  or  even  blue-black 
appearance,  while  from  around  it  oozes  a  slight  discharge 


332         DISEASES  OF  THE  HORSE'S  FOOT 

of  pus,  yellow  in  colour  and  non-offensive,  or  blood-stained 
and  dark  in  appearance,  and  foetid  to  the  smell. 

Almost  invariably  these  symptoms  are  added  to  by  a 
more  or  less  diffuse  and  oedematous  swelling  of  the  lower 
portion  of  the  limb,  extending  in  some  cases  to  as  high 
as  the  fetlock  or  the  upper  third  of  the  cannon. 

With  the  casting  off  of  the  slough  the  phenomena  of 
inflammation  to  a  great  extent  subside,  the  pain  ceases, 
and  the  case  under  ordinary  conditions  commences  to 
mend. 

Pathological  Anatomy. — In  its  early  stages  the  condition 
of  simple  or  cutaneous  quittor  is  really  a  condition  of  acute 
coronitis  (see  p.  229),  and  consists  in  an  inflammation  of 
the  subcutaneous  tissue,  and  the  more  superficial  portions 
of  the  coronary  cushion.  The  tissues  implicated  are  de- 
stroyed outright,  become  infiltrated  with  the  inflammatory 
exudate  and  escaped  blood,  and  acts  as  a  source  of  irritation 
expdate  and  escaped  blood,  and  act  as  a  source  of  irritation 
latter,  as  we  have  said  before,  cast  the  necrosed  portion 
away  by  a  process  of  sloughing. 

Always,  however,  it  is  found  that  the  portion  to  be 
sloughed  off,  while  easily  separated  from  the  tissues  adjacent 
to  its  sides,  is  closely  connected  on  its  lowermost  or  deeper 
face  with  the  structures  below,  and  cannot  be  torn  away 
without  haemorrhage  and  the  causing  of  acute  pain. 

Prognosis. — With  wounds  about  the  feet  our  forecast 
should  always  be  guarded.  Even  with  this,  the  most  simple 
form  of  quittor,  no  decided  opinion  should  be  given  until 
the  progress  of  the  case  warrants  one  in  reasonable  assuming 
that  complications  are  absent.  Once  this  point  is  decided, 
a  favourable  prognosis  may  be  given. 

Complications. — With  cutaneous  quittor  various  com- 
plications may  arise,  according  to  the  extent  of  the  invasion 
of  the  septic  matter.  Necrosis  of  tendon,  of  ligament,  or  of 
cartilage,  caries  of  the  bone,  or  a  condition  of  synovitis  and 
arthritis  may  be  met  with.  As  these  complications  are 
equally  common  to  sub-horny  quittor,  we  shall  reserve  their 
description  until  dealing  with  that  condition. 


DISEASES  OF  THE  LATERAL  CARTILAGES     333 

Treatment  (Preventive ) . — Immediately  after  the  infliction 
of  an  injury  in  this  position,  more  especially  if  it  is  such  as 
to  lead  one  to  judge  that  necrosis  will  follow  to  any  large 
extent,  the  patient  should  be  rested.  Ill  effects  may  then 
be  probably  warded  off  by  having  the  foot  immersed  in  a 
cold  antiseptic  solution,  and  afterwards  bound  with  an  anti- 
septic pad  and  bandage. 

Curative. — When  the  condition  has  gone  undiscovered 
until  commencing  necrosis  and  suppuration  are  plainly 
discernible,  then  the  wisest  course  we  can  follow  is  to  do  all 
we  can  to  hasten  removal  of  the  necrosed  portion. 

This  is  best  done  by  promoting  the  suppurative  process 
by  means  of  warmth  or  stimulant  applications. 

To  this  end  hot  poultices,  or,  better  still,  hot  baths, 
should  be  resorted  to.  LTnder  their  influence  a  greater 
supply  of  blood  is  directed  to  the  still  healthy  tissues 
enabling  them  to  actively  continue  the  inflammatory  pro- 
cesses necessary  to  the  detaching  of  the  portion  necrosed, 
while,  at  the  same  time,  the  pus  organisms,  stimulated  by 
the  heat,  are  stirred  into  greater  activity,  and  the  readier 
accomplish  their  purpose  of  destroying  the  adhesion  still 
existing  between  the  necrotic  portion  and  the  surrounding 
living  tissues. 

When  prolonged  poulticing  or  bathing  cannot  be  prac- 
tised, then  the  swelling  should  be  stimulated  with  a  sharp 
cantharides  blister,  repeated,  if  the  case  demands  it,  at 
intervals  of  a  few  days. 

Should  the  swelling  show  distinct  signs  of  pointing,  and 
an  abscess  is  plainly  the  condition  to  be  dealt  with,  its  con- 
tents should  be  liberated  by  a  free  use  of  the  knife.  In  this 
connection  it  is  important  to  insist  on  the  fact  that  the 
opening  should  be  made  large  enough.  One  bold  incision 
from  the  uppermost  limit  of  the  swelling  down  to  the 
coronary  margin  of  the  wall  is  usually  sufficient. 

Even  when  pointing  is  not  very  evident,  and  suppuration 
is  plainly  more  or  less  diffuse,  benefit  may  still  be  derived 
from  the  use  of  the  knife.  In  this  case  a  deep  scarification 
of   the  part   is   indicated.     Three,    four,   or   more   vertical 


334        DISEASES  OF  THE  HORSE'S  FOOT 

incisions  are  made  in  the  swelling,  and  from  them  obtained 
a  flow  of  blood  mingled  with  a  small  quantity  of  pus  from 
several  different  centres.  By  this  means  sloughing  of  the 
diseased  portion  is  quickly  obtained,  and  nothing  but  an 
ordinary  open  wound  left  for  treatment.  It  should  be  men- 
tioned, however,  that  when  sloughing  can  be  in  any  way 
induced  to  take  place  naturally  it  is  better  to  allow  this 
to  take  place.  Even  when  the  necrosed  portion  is  freely 
movable,  and  only  adherent  by  its  base,  it  should  not  be 
forcibly  removed,  but  left  to  the  slower  but  more  effectual 
action  of  the  tissue  reactions.  If  torn  forcibly  away,  we  in 
all  probability  leave  in  the  bottom  of  the  wound  remnants 
of  the  dead  tissue,  which,  being  small  and  consequently  less 
productive  of  inflammatory  phenomena,  are  not  so  readily 
sloughed  as  the  larger  portion.  These  remain  as  centres  of 
infection,  and  prolong  the  case. 

Once  a  suitable  slough  has  occurred,  the  after-treatment 
is  simple.  It  consists  in  dressing  the  wound  with  reliable 
antiseptics,  and  maintaining  the  parts  in  a  healthy  con- 
dition until  Nature  completes  the  cure  by  repairing  the 
breach.  Solutions  of  carbolic  acid,  of  perchloride  of  mer- 
cury, of  zinc  chloride,  or  of  moderately  strong  solutions  of 
copper  sulphate,  are  all  of  them  useful  (see  also  treatment 
of  coronitis  on  p.  236). 

It  is  sometimes  found  that  even  with  careful  attention 
the  wound  left  by  the  removal  of  the  slough  shows  a  marked 
disinclination  to  heal.  The  greater  portion  of  the  cavity 
becomes  filled  with  granulation  tissue,  and  the  epidermis 
gradually  closes  round  until  all  is  covered"  except  a  spot  of 
perhaps  the  size  of  half  a  crown  or  a  crown  piece.  Here 
the  regenerative  process  stops,  and  the  wound  obstinately 
refuses  to  effectually  close. 

In  such  cases  we  have  derived  excellent  results  with  the 
actual  cautery.  The  animal  is  cast,  the  foot  firmly  secured 
by  fastening  it  upon  the  cannon  of  another  limb,  and  the 
animal  chloroformed.  A  practical  point  to  be  remembered 
in  this  connection  is  that  all  necessary  fixing  of  the  limb  is 
easier  performed  if  the  chloroform  is  administered  first. 


DISEASES  OF  THE  LATERAL  CARTILAGES     335 

With  the  patient  thus  secured  we  first  of  all  ascertain  by 
means  of  the  probe  whether  or  no  the  non-healing  of  the 
wound  is  due  to  the  presence  of  a  fistula.  Decided  in  the 
negative,  we  take  an  ordinary  flat  firing-iron,  and  with  it 
cut  away  a  portion  of  the  skin  immediately  around  the  still 
open  wound,  carrying  our  incisions  deep  enough  to  '  scoop  ' 
out  a  large  portion  of  the  new  inflammatory  tissue  beneath. 
With  the  loss  of  pressure  from  beneath,  occasioned  by  the 
removal  of  so  much  of  the  cicatricial  tissue,  the  epidermis 
the  more  readily  closes  over  the  wound.  To  a  large  extent 
also  this  new  growth  of  epidermis  is  helped  by  the  renewal 
of  the  inflammatory  phenomena  brought  into  being  with 
the  cauterization. 

2.     Sub-horny  Quittor. 

Definition. — A  fistulous  wound  of  the  foot  in  which  the 
low^er  and  blind  end  of  the  fistula  is  situated  below  the 
level  of  the  coronary  margin  of  the  wall. 

Causes. — These,  again,  will  be  practically  the  same  as 
those  mentioned  in  the  cause  of  cutaneous  quittor  — 
namely,  bruises,  punctures,  wounds — in  fact,  any  injury 
upon  the  coronet  severe  enough  to  cause  death  of  tissue 
and  a  suppurating  wound.  We  may  thus  expect  sub-horny 
quittor  to  follow  upon  treads,  overreach,  accidental  injuries 
with  the  stable-fork  and  kicks  from  other  animals. 

Sub-horny  quittor  may  also  arise  without  original  injury 
at  all  to  the  coronet.  Either  from  a  violent  blow  upon  the 
hoof,  or  from  the  animal  himself  kicked  violently  against 
a  wall,  death  of  a  portion  of  the  sensitive  structures  takes 
place  within  the  hoof,  suppuration  ensues,  and  the  forma- 
tion of  quittor  commences.  With  the  escape  of  the  pus  at 
the  coronet  the  quittor  is  fully  formed. 

Any  other  diseased  condition  of  the  foot  in  which  sup- 
puration is  present  may  in  like  manner  terminate  in  quittor. 
In  complicated  sand-crack,  suppurating  corn,  or  in  ordinary 
pricked  foot  quittor  may  be  a  sequel.  In  these  conditions 
the  pus  formation  either  goes  unnoticed  or  is  neglected, 
and  after  seriously  invading  the  sensitive  structures  within 


336        DISEASES  OF  THE  HORSE'S  FOOT 

the  hoof,  breaks  out  at  the  coronet.  Again,  too,  as  with 
the  simpler  form  of  quittor,  and  as  with  coronitis,  we  may 
always  regard  as  a  predisposing  cause  the  action  of  exces- 
sive cold  in  promoting  septic  infection  of  the  wound  when 
occurring  at  the  coronet. 

Symptoms  and  Diagnosis. — Where  the  fistulous  wound 
has  had  its  starting-point  in  an  injury  to  the  coronet  diag- 
nosis is,  of  course,  easy.  The  history  of  the  case  explains 
it.  Nothing  in  this  instance  remains  but  to  probe  the 
opening,  and  ascertain  its  direction,  depth,  and  extent. 

An  animal  with  the  wound  thus  open  at  the  coronet,  and 
freely  discharging  its  contents,  may,  if  no  serious  com- 
plications exist,  walk  tolerably  sound.  It  is  only  when  put 
to  the  trot  that  symptoms  of  lameness  are  apparent. 

It  may  so  happen,  however,  that  we  first  see  the  case 
when  the  symptoms  are  wholly  those  arising  from  a  painful 
suppuration  within  the  horny  box.  This  occurs  when  the 
original  injury  has  taken  place  at  a  more  dependent  posi- 
tion than  the  coronet.  Either  from  violent  blows  upon  the 
hoof,  puncture  from  below,  from  corn  or  from  sand-crack, 
or  any  other  causes  we  have  enumerated,  suppuration  is 
occurring  deeply  within  the  hoof,  with  as  yet  no  opening 
upon  the  coronet. 

Even  when  an  opening  has  already  occurred  on  the 
coronet,  the  same  condition  of  sub-horny  suppuration  may 
be  met  with  in  cases  when  the  opening  of  the  fistula  has  by 
some  means  or  other  become  occluded.  Granulation  tissue, 
for  instance,  may  have  temporarily  closed  the  mouth  of 
the  fistula.  The  pus,  instead  of  continuing  its  discharge 
thereat,  is  made  to  burrow  in  other  directions. 

In  either  of  these  cases  pain  is  excessive,  the  animal 
walks  on  three  legs,  the  foot  is  painful  to  percussion,  and 
grave  constitutional  disturbance  is  noticeable.  The  pre- 
sence of  pus  is  immediately  suspected,  and,  in  the  absence 
of  any  indication  of  an  opening  having  existed  at  the 
coronet,  searched  for  at  the  sole.  It  may  or  may  not  be 
found.  If  found  it  is  given  exit,  and  the  case  ends  as  one 
of  ordinary  pricked  foot,  of  suppurating  corn,  or  some  other 


DISEASES  OE  THE  LATERAL  CARTILAGES    337 

condition  equally  simple  when  compared  with  quittor.  In 
those  cases  where  the  pus  is  not  discovered  at  the  sole,  one 
adopts  the  expectant  treatment  of  poulticing.  This,  if  pus 
is  present,  is  followed  by  a  painful  swelling  of  the  coronet. 
At  one  point  there  forms  a  hot  and  tender  enlargement,  with 
the  hairs  on  it  standing  straight  up  from  the  skin,  which 
latter  is  seen  below  red  and  inflamed  in  appearance. 

Later,  the  abscess — for  abscess  it  is — discharges  its  con- 
tents, the  opening  is  explored,  and  we  find  that  in  extent  it 
is  not  confined  to  the  coronary  region,  but  that  it  is  deep 
enough  to  constitute  a  true  sub-horny  quittor. 

This  discharge  of  the  abscess  contents  may  take  place  at 
a  well-defined  spot  on  the  coronet,  or  it  may  ooze  out  at 
the  junction  of  the  wall  with  the  skin.  In  appearance  the 
discharged  pus  varies.  When  the  softer  structures  only 
are  attacked  it  is  thick,  and  yellow  or  white  in  colour; 
when  bone  is  involved  it  is  ichorous ;  and  when  attacking 
the  horn  itself  black  or  gray.  It  may  or  may  not  be 
extremely  foetid,  and  often  it  is  mingled  with  blood. 

When  evidence  of  a  previous  opening  upon  the  coronet 
is  plain,  then  it  is  not  considered  wise  to  attempt  a  paring 
of  the  sole.  Instead,  poulticing  is  at  once  resorted  to,  to 
induce  the  discharge  of  the  pus  through  its  original 
channel.  Once  this  has  occurred  a  fistulous  wound  re- 
mains, which  is  open  for  treatment  upon  one  or  other  of 
the  lines  we  shall  afterwards  indicate. 

Complications  (a)  Necrosis  of  the  Lateral  Cartilage. — 
This  is  the  so-called  '  cartilaginous  quittor  '  of  other  writers. 
In  all  probability  it  is  the  condition  generally  understood 
when  the  word  '  quittor  '  is  used  by  one  practitioner  to  the 
other.  Its  tendency  to  keep  the  disease  existing  in  a  chronic 
form  renders  it  of  grave  importance,  and  for  that  reason 
we  give  it  first  mention  among  the  complications. 

It  may  occur  as  a  sequel  either  of  cutaneous  or  of  sub- 
horny  quittor,  and  may  result  either  from  actual  wounding 
and  infection  of  the  cartilage,  or  from  an  attack  on  it  of 
septic  matter  originating  elsewhere. 

Unless   there   has   been   discovered   a   fistula,   which   on 


338        DISEASES  OF  THE  HORSE'S  FOOT 

probing  is  seen  to  lead  direct  to  the  position  in  which  we 
know  the  cartilage  to  be,  we  know  of  no  precise  means  by 
which  the  existence  of  this  condition  may  be  diagnosed. 
When  free  from  other  complications,  the  horse  with  his 
foot  in  this  state  may  travel  fairly  sound.  This  is  so  when 
the  necrosis  is  situated  in  the  posterior  half  of  the  cartilage, 
in  which  case  the  irritation  set  up  by  the  disease  is  confined 
to  the  comparatively  non-sensitive  tissues  of  the  cartilage 
itself  and  the  fibrous  mass  of  the  plantar  cushion.  When 
attacking  the  anterior  half  of  the  cartilage,  the  close  con- 
tiguity of  the  joint  renders  the  disease  of  a  more  serious 
nature.  It  is  then  that  we  have  acute  pain,  and  with  it 
extreme  lameness,  for  in  this  position  it  is  more  than  likely 
that  we  have  involved  either  the  synovial  membrane  of  the 
articulation  or  the  tops  of  the  sensitive  laminae.  It  will  be 
remembered  that  here  the  synovial  membrane  protrudes  as 
a  small  sac  between  the  antero-  and  postero-lateral  liga- 
ments of  the  joint.  More  or  less  easily  then  it  is  bound  to 
come  into  intimate  contact  with  the  septic  matter  attending 
the  necrosis  of  the  cartilage,  and  so  share  in  the  inflam- 
matory processes,  afterwards  communicating  them  to  the 
interior  of  the  articulation. 

With  necrosis  of  the  lateral  cartilage  is  always  swelling 
and  thickening  of  the  skin  and  subcutaneous  structures  of 
the  coronet.  This  is  the  greater  the  longer  the  disease  has 
been  in  existence.  Upon  the  swelling  is  seen  the  mouth  of 
the  fistula,  or  it  may  be  the  mouths  of  several,  and  from 
them  all  a  discharge  of  pus. 

The  mouth  of  each  fistula  is  generally  filled  with  a 
mulberry-like  granulation  tissue,  standing  above  the  level 
of  the  skin,  and  bleeding  easily  if  touched.  The  exuding 
pus  is  thin  and  pale  gray  in  appearance,  gritty  to  the 
touch,  and  generally  free  from  pronounced  smell.  At 
other  times  its  colour  is  reddened  with  contained  blood, 
and  floating  in  it  are  tiny  particles  of  a  pale-green  sub- 
stance, which  when  picked  up  and  rubbed  between  the 
fingers  are  seen  to  be  small  fragments  of  the  diseased 
cartilage. 


DISEASES  OF  THE  LATERAL  CARTILAGES  339 

Should  the  mouth  of  a  fistula  become  occluded  with  the 
granulations  filling  it,  and  the  discharge  prevented  from 
escaping,  it  soon  happens  that  we  have  close  to  the  fistula 
that  has  closed  a  tender  fluctuating  swelling.  This  points 
and  breaks,  and  pus  is  again  discharged  from  another 
opening.  In  this  manner  is  accounted  for  the  multiplicity 
of  scars  and  fistulas  seen  on  the  swelling  of  an  old- 
standing  quittor. 

The  continued  inflammation  thus  kept  in  existence  has 
the  effect  of  rendering  the  skin  and  subcutaneous  tissues 
in  the  neighbourhood  greatly  thickened  and  indurated. 
This  in  time  leads  to  a  tumor-like  enlargement,  and  causes 
the  structures  of  the  coronet  to  greatly  overhang  the  hoof. 
At  the  same  time  the  constant  inflammation  has  made  its 
stimulant  effects  noted  in  a  great  increase  in  the  growth  of 
the  horn  of  the  wall. 

Although  more  abundant,  however,  the  quality  of  the 
horn  is  deteriorated.  The  perioplic  ring  has  become 
obliterated,  and  the  varnish-like  appearance  of  the  healthy 
wall  destroyed.  Cracks  and  fissures  in  its  surface  are 
numerous,  and  sometimes  deep  enough  to  lead  to  exposure 
of  the  sensitive  structures  beneath,  complicating  the  quittor 
with  a  sand-crack  of  a  peculiarly  objectionable  type. 

Pathological  Anatomy  of  the  Diseased  Cartilage. — The 
bulk  of  observers  appear  to  agree  in  the  statement  that  in 
quittor  the  necrotic  cartilage  is  pea-green  in  colour,  and 
recognize  it  by  that  characteristic.  In  size  the  necrotic 
portion  thus  recognisable  varies  from  the  tiniest  speck  to 
a  portion  the  size  of  a  horse-bean.  Commonly,  however, 
it  is  about  as  large  only  as  a  pea.  It  is  seen  to  be  more  or 
less  detached  from  the  rest  of  the  cartilage,  to  which  it 
is  adherent  by  one  of  its  extremities  only.  In  general 
appearance  we  can  best  liken  it  to  the  split  half  of  a  green 
pea,  whilst  others  have  compared  it  with  the  green 
sprouting  of  a  seed.  The  portions  of  cartilage  nearest  the 
necrotic  piece  are  also  slightly  green  in  colour,  thus  indi- 
cating that  here  also  the  diseased  process  has  commenced. 
This  peculiar  change  of  colour  in  the  affected  cartilage  is 


340        DISEASES  OF  THE  HORSE'S  FOOT 

of  great  importance  to  the  surgeon.  It  enables  him  when 
operating  to  distinguish  with  some  degree  of  certainty 
those  portions  of  the  cartilage  which  are  healthy  and  those 
which  are  not. 

(b)  Necrosis  of  Tendon  and  of  Ligament. — This  compli- 
cation of  quittor  is,  as  we  have  said  before,  treated  by 
other  writers  as  a  distinct  form  of  the  disease,  and  de- 
scribed by  them  under  the  heading  of  Tendinous  Quittor. 

This  simply  means,  of  course,  that  the  diseased  process 
has  extended  to  either  of  the  flexor  tendons,  to  the  tendon 
of  the  extensor  pedis,  or,  perhaps,  to  the  ligaments  of  the 
pedal  articulation. 

Of  the  flexor  tendons,  the  perforans  is  the  one  commonly 
attacked,  by  reason,  of  course,  of  its  more  superficial 
position.  At  times,  however,  especially  when  its  aponeu- 
rotic expansion  is  diseased,  the  necrosis  of  the  perforans 
spreads  until  the  aponeurosis  is  eaten  through  and  the 
phalangeal  sheath  penetrated.  Septic  materials  gain 
entrance  thereto,  and  commence  to  multiply.  In  this  way 
the  flexor  perforatus  is  invaded,  and  comes  to  share  in  the 
diseased  process. 

The  extensor  pedis  is  usually  attacked  by  extension  of 
the  disease  from  a  necrotic  cartilage,  or  results  from  the 
infliction  of  a  severe  tread  in  a  hind-foot.  In  this  case  the 
diseased  structure  has  nothing  between  it  and  the  articula- 
tion, the  synovial  membrane  in  one  position  actually  lining 
its  inner  face.  The  result  is  that  a  condition  of  synovitis 
is  easily  set  up,  and  the  case  aggravated  by  that  and  by 
arthritis. 

With  the  flexor  tendons  attacked  pain  is  always  very 
great,  and  lameness  is  excessive.  This,  however,  is  not 
sufficiently  characteristic  to  enable  us  to  determine  the 
precise  seat  of  the  necrotic  changes.  Later,  however,  a 
tender  but  hard  enlargement  made  its  appearance  in  the 
hollow  of  the  heel,  which  enlargement,  later  still,  became 
soft  and  fluctuating.  At  this  stage  there  is  also  consider- 
able swelling  along  the  whole  course  of  the  tendons,  as 
high   up   as   the  knee   or   the   hock.    The   foot  is   carried 


DISEASES  OF  THE  LATERAL  CARTILAGES.  341 

forward  with  all  the  phalangeal  articulations  flexed,  and 
in  many  cases  the  limb  is  unable  to  take  weight  at  all. 
Manipulated  after  the  manner  of  examining  the  tendons 
for  sprain,  this  swelling  is  found  to  be  extremely  painful. 
The  animal  flinches  from  the  hand,  and  shows  every  sign 
of  acute  suffering.  This  condition  may,  in  fact,  be  mis- 
taken for  sprain,  and  is  only  to  be  distinguished  from  it  by 
carefully  noting  the  history  of  the  case — first,  the  appear- 
ance of  the  swelling  in  the  hollow  of  the  heel,  and,  secondly, 
the  a/ter-swelling  of  the  upper  portions  of  the  tendons. 

The  formation  of  the  abscess,  the  after-discharge  of  its 
contents,  and  the  final  establishing  of  a  fistula,  are  pro- 
cesses greatly  prolonged  in  this  form  of  quittor.  It  will 
readily  be  understood  why  this  should  be  so  when  one 
remembers  the  depth  at  which  the  suppurative  process  is 
going  on,  the  thickness  of  the  metacarpo-phalangeal  sheath, 
and  the  resistant  nature  of  the  material  of  wrhich  this  latter 
is  made,  and  which  must  be  penetrated  before  the  condition 
becomes  observable. 

After  the  opening  of  the  abscess,  which  usually  takes 
place  in  the  hollow  of  the  heel,  there  is  left  the  fistulous 
wound  which  obstinately  refuses  to  heal.  Or  it  may  be, 
again,  that  there  are  several  of  these  fistulas,  each  opening 
in  the  heel,  and  the  mouth  of  each  marked  by  a  small, 
ulcer-like  projection.  The  discharge  continually  oozing 
from  these  keeps  the  heel  constantly  wet  with  a  thick 
purulent  discharge,  which  is  nearly  always  blood-stained, 
and  very  often  foetid. 

This  constitutes  what  is  known  as  tendinous  quittor  in 
its  worst  form,  for  more  often  than  not  there  is  associated 
with  it  inflammation  of  the  navicular  bursa,  caries  of  the 
bones,  or  arthritis  of  the  pedal  articulation. 

With  the  extensor  pedis  attacked  matters  are  not  quite 
so  grave,  in  spite  of  the  fact  that  the  articulation  is  closely 
situated  thereto,  for  in  this  case  the  more  superficial  position 
of  the  diseased  structure  allows  both  of  readier  exit  of  the 
discharges  and  of  easier  removal  of  the  necrosed  portion 
and  after-treatment  of  the  wound. 


342         DISEASES  OF  THE  HORSE'S  FOOT 

(c)  Caries  of  the  Bones. — Portions  of  the  os  pedis,  more 
especially  of  its  wings,  and  therefore  usually  occurring  in 
conjunction  with  necrosed  cartilage,  become  carious  in 
quittor.  In  many  cases  it  is  impossible  to  say  with  cer- 
tainty when  this  has  occurred.  In  a  few  instances,  how- 
ever, the  exuding  discharge  gives  evidence  of  what  has 
happened.  It  is  thin,  but  extremely  offensive,  with  the 
characteristic  odour  of  decayed  bone  or  tooth,  and  with  a 
feel  that  is  gritty  with  contained  particles  of  broken-up 
bone.  If,  with  a  discharge  of  this  nature  present,  the 
probe  also  conveys  to  the  fingers  the  sensation  that  bone  is 
reached,  then  diagnosis  may  be  sure. 

(d)  Ossification  of  the  Cartilage. — This  may  take  place 
in  part  or  in  whole.  It,  of  course,  constitutes  Side-bone,  a 
fuller  description  of  which  will  be  found  in  a  later  portion 
of  this  chapter. 

(e)  Penetration  of  the  Articulation. — This  may  occur 
either  as  a  result  of  the  suppurative  changes  or  as  an  acci- 
dent in  excision  of  the  diseased  cartilage.  Unless  it  is 
followed  by  a  severe  purulent  arthritis,  it  is  not  so  grave  a 
complication  as  at  first  sight  it  would  appear. 

(/)  Synovitis  and  Arthritis  {Purulent). — Should  this  com- 
plication arise,  the  case  is  a  most  serious  one.  Beyond  here 
mentioning  the  fact  that  it  may  occur,  we  shall  not  dwell 
on  it.     Fuller  consideration  is  given  to  it  in  Chapter  XII. 

Treatment. — The  various  treatments  adopted  for  the  cure 
of  sub-horny  quittor  offer  the  veterinary  surgeon  a  large 
number  to  select  from.  We  will  describe  them  in  the  order 
in  which  they  are,  perhaps,  most  commonly  practised. 

Poultices  and  Hot  Baths. — As  in  cutaneous  quittor,  and 
as  in  coronitis,  when  the  pus  formation  is  only  suspected, 
and  has  not  yet  broken  out  at  the  coronet  or  elsewhere, 
then  the  first  indication  in  treatment  is  the  use  of  warm 
poultices  or  of  hot  baths.  Their  application  is  in  most 
cases  productive  of  pointing  at  the  coronet. 

Directly  this  appears  it  is  a  wise  plan  to  thir±  the  wall 
down  with  the  rasp  immediately  below  the  swelling.  Tp 
some  extent  it  relieves  the  pressure  of  the  inflammatory 


DISEASES  OF  THE  LATERAL  CARTILAGES  343 

products  within,  and  at  the  same  time  paves  the  way  for 
operative  measures  which  may  be  necessary  later  on. 

With  the  breaking  of  the  abscess  and  the  discharging  of 
its  contents,  we  may  in  some  measure  ascertain  the  con- 
dition we  have  to  deal  with.  The  probe  is  used,  and  the 
abscess  cavity  explored.  The  size  of  the  wound,  its  depth 
below  the  upper  margin  of  the  wall,  the  structures  involved, 
and  other  information,  may  be  thus  obtained. 

At  first,  however,  the  nature  of  the  wound,  and  the 
character  of  the  discharges,  must  largely  guide  us  as  to 
the  treatment  we  adopt.  In  many  cases,  even  where  the 
abscess  cavity  is  far  below  the  upper  margin  of  the  wall. 
and  is  presumably  in  an  unfit  position  to  drain  and  heal,  a 
regular  application  of  an  astringent  and  antiseptic  dress- 
ing is  sufficient  to  bring  about  resolution.  If,  however,  the 
discharge  from  the  wound  continues  to  be  liquid,  and  the 
wound  itself  at  one  spot  refuses  to  heal,  it  may  be  judged 
that  a  portion  of  necrotic  tissue  is  situated  under  the  wall, 
and  affecting  the  laminae,  the  cartilage,  or  ligament,  as  the 
case  may  be.  If  this  is  so,  then  operative  measures  must 
be  determined  on  (see  Removal  of  the  Wall,  p.  349). 

Blisters. — Instead  of  the  poultice  and  hot  baths,  the 
pointing  of  the  abscess  and  the  casting  off  of  the  slough 
may  be  brought  about  by  the  application  of  a  sharp  can- 
tharides  blister.  We  have,  in  fact,  seen  many  cases  where 
this  treatment  was  adopted  prior  to  the  formation  of  a 
fistula,  and  also  in  cases  where  one  or  more  fistulous  open- 
ings already  existed,  where  repeated  blisters  to  the  coronet 
have  alone  been  sufficient  to  effect  a  cure. 

We  are  bound  to  admit,  however,  that  the  treatments  of 
poulticing  and  blistering  are  only  expectant — we  might 
almost  say  empirical.  At  any  rate,  we  admit  to  ourselves 
that  what  we  have  advised  and  carried  out  is  not  in  itself 
curative,  but  only  a  means  of  assisting  Xature  to  satisfac- 
torily work  her  own  ends.  Empirical  or  not,  however,  we 
believe  that  in  every  case  of  quittor  it  is  wise  in  practice  to 
at  first  adopt  some  such  simple  measure,  for  in  nearly  even- 
instance  where  operative  measures  are  practised,  the  patient 


344        DISEASES  OF  THE  HORSE'S  FOOT 

must  be  laid  aside  for  at  least  several  weeks,  whereas  in 
this  way  he  may  be  kept  at  work  and  a  cure  effected  at  the 
same  time. 

The  Actual  Cautery. — Largely  of  the  same  empirical 
nature,  yet  doing  something  a  little  more  calculated  to 
destroy  necrotic  tissue  and  bring  about  its  sloughing  is  the 
use  of  the  cautery,  both  actual  and  potential. 

The  actual  cautery  may  be  beneficially  employed  for  the 
relief  of  sub-horny  quittor  in  at  least  two  ways. 

In  the  first  place,  it  is  often  used — a  blunt  '  point-firing ' 
iron  being  the  instrument — instead  of  the  knife  as  a  means 
of  evacuating  the  contents  of  the  coronary  abscess.  Those 
who  use  it  for  this  purpose  are  able  to  say  this  in  its 
favour :  it  brings  about  the  opening  of  the  abscess  without 
the  unsightly  haemorrhage  attending  the  use  of  the  knife, 
and  at  the  same  time  just  as  effectually  empties  it.  The 
opening  made  is  not  nearly  so  likely  to  close  prematurely — 
that  is,  before  a  proper  course  of  treatment  of  the  wound 
has  been  carried  out — and  so  leave  necrotic  tissue  at  its 
bottom.  The  intense  tissue  reaction  it  sets  up  is  productive 
of  a  large  slough,  cast  off  by  highly  active  inflammatory 
phenomena,  which  means  that  the  remaining  wound  is  one 
in  which  no  dead  tissue  is  left,  and  which  is  more  amenable 
to  treatment. 

We  have  also  seen  the  actual  cautery  used  in  sub-horny 
quittor,  where  that  disease  has  reached  a  chronic  fistulous 
stage,  as  a  means  of  cauterizing  the  whole  length  of  the 
lining  of  each  fistulous  passage. 

At  the  present  day  this  method  is  regarded  as  barbarous, 
and  savouring  too  largely  of  the  methods  and  practice  of 
the  old  empirics.  There  is  no  denying  the  fact,  however, 
that  it  is  at  times  followed  by  a  speedy  and  complete  cure 
of  what  has  for  months  been  an  intractable  and  apparently 
incurable  quittor;  and,  honestly  speaking,  we  ourselves  can 
see  nothing  very  greatly  against  the  operation  in  certain 
cases  save  its  appearance.  In  that  it  is  certainly  rough, 
and  is  not  calculated  to  favourably  impress  the  more 
critical  of  our  clientele.     With  the  animal   chloroformed, 


DISEASES  OF  THE  HORSE'S  FOOT         345 

however,  much  of  what  can  really  be  urged  against  it  dis- 
appears, and  on  farms  and  other  places  where  a  skilled  and 
competent  dressing  of  an  operation  wound  cannot  be  looked 
for,  it  is  sometimes  wise  to  advise  this  method  of  treatment 
in  preference  to  more  advanced  methods  of  operating.  So 
far  as  we  can  judge,  the  after-effects  are  very  little  worse 
than  those  following  other  operative  measures,  more 
especially  when  a  suitable  case  has  been  chosen. 

This  method  of  treatment  is  particularly  applicable  to 
cases  of  chronic  sub-horny  quittor  in  the  more  posterior 
parts  of  the  foot.  Here,  if  one  or  more  fistulas  exist,  their 
openings  are  probed  and  the  direction  of  the  sinuses  deter- 
mined. In  all  probability  they  are  burrowing  down  along- 
side the  wall  to  the  sole,  where,  for  want  of  outlet,  they  are 
invading  the  substance  of  the  plantar  cushion  or  the  plantar 
aponeurosis. 

Should  this  preliminary  probing  demonstrate  that  neither 
of  the  fistulas  run  dangerously  near  the  joint,  then  the 
operation  may  be  decided  on. 

The  animal  is  cast  and  chloroformed,  the  foot  firmly 
fixed,  and  the  horn  of  the  quarter  rasped  away  quite  thin. 
The  sole  of  the  same  is  also  pared  with  the  knife  until 
the  horn  of  both  the  quarter  and  the  sole  yields  easily  to 
pressure  of  the  thumb.  All  that  is  then  needed  is  three  or 
four  long,  round,  and  pointed  irons  (about  £  to  f  inch  in 
diameter)  heated  to  redness.  These  are  inserted  into  the 
fistulas,  and  the  false  mucous  coat  of  these  passages  thus 
destroyed.  When  the  iron,  on  being  directed  into  the 
fistulous  opening  at  the  coronet,  is  found  to  travel  alongside 
the  wall,  and  to  easily  reach  the  sole,  it  should  be  made  to 
go  further  still.  The  sole  is  penetrated,  and  a  dependent 
opening  thus  made  for  the  escape  of  the  discharge  that 
afterwards  accumulates. 

What  happens  now,  of  course,  is  that  an  intense  and 
^ute  inflammation  is  set  up  along  the  whole  track  of  the 
fistula,  in  which  position  the  inflammatory  changes  were 
heretofore  chronic.  The  whole  lining  of  the  fistula,  and 
with  it,  we  hope,  all  necrotic  tissue,  is  cast  as  a  slough, 


346        DISEASES  OF  THE  HORSE'S  FOOT 

leaving  nothing  but  healthy  tissue  behind.  This,  with  a 
suitable  dressing,  heals  and  gives  no  further  trouble. 

The  after-treatment  consists  in  the  application  of  hot 
poultices.  These  tend  to  greatly  ease  the  pain,  and  at  the 
same  time  to  facilitate  the  removal  of  the  slough.  The 
poulticing  should  be  continued,  therefore,  until  the  sloughing 
comes  about,  which  happens,  as  a  rule,  at  about  the  fifth  or 
seventh  day. 

Immediately  the  slough  is  cast  off,  the  poultices  may  be 
discontinued  and  dressing  of  the  wound  carried  out.  This 
consists  of  injections  of  solutions  of  zinc  chloride  1  in  200, 
p.?rchloride  of  mercury  1  in  1,000,  carbolic  acid  1  in  20,  of 
Villate's  solution,  or  of  such  other  antiseptic  as  the  surgeon 
may  think  fit.  The  dependent  orifice  at  the  sole  should  be 
kept  open  for  as  long  as  possible,  being  occasionally  trimmed 
round  with  the  drawing-knife,  and  scooped  out  with  a 
sharp-edged  director. 

Directly  a  healthy  and  pink-looking  granulation  is 
observed  along  the  track  of  the  iron,  and  the  discharge 
therefrom  takes  on  a  thick  and  yellow  appearance,  the 
strength  of  the  antiseptic  solutions  should  be  gradually 
diminished.  This  point,  in  fact,  is  of  great  importance  in 
treating  all  wounds  of  the  foot.  There  is  a  great  temptation, 
on  account  of  the  known  excessive  liability  of  the  parts  to 
septic  infection,  to  use  an  antiseptic  solution  unduly  strong. 
What  must  be  remembered  is  that  used  too  strong  they 
themselves  give  rise  to  dead  tissue,  or  to  impermeable  layers 
consisting  of  compounds  of  the  discharges  with  themselves, 
and  so  create  substances  that  prove  a  source  of  irritation 
and  subsequent  trouble. 

The  Potential  Cautery. — This  is  employed  in  the  treat- 
ment of  sub-horny  quittor,  either  in  the  solid  form  (in 
sticks,  in  lumps,  or  in  the  powder),  or  in  the  liquid  form, 
when  it  is  injected  with  a  quittor  syringe. 

In  the  former  method  such  drugs  as  perchloride  of  mer- 
cury in  the  lump,  or  nitrate  of  silver,  chloride  of  zinc,  and 
caustic  potash  or  soda  in  the  stick,  are  introduced  into 
each  of  the  sinuses  present.  This  is  done  by  means  of 
a  director  or  a  probe. 


DISEASES  OF  THE  LATERAL  CARTILAGES  347 

A  better  method,  however,  when  the  dressing  lends  itself 
to  the  purpose,  is  to  use  it  in  the  form  of  a  powder,  wrapped 
in  the  form  of  small  cubes  in  extremely  thin  paper,  such, 
for  instance,  as  is  used  for  rolling  cigarettes.  It  is  then 
conveniently  inserted  into  each  fistula.  Introduced  in  this 
more  finely  divided  form  the  drug  is.  perhaps,  a  little  more 
active  in  bringing  about  the  desired  result. 

This  method  of  '  plugging,'  although  practised  by  many, 
we  cannot  recommend  in  preference  to  the  use  of  the  hot 
iron  or  of  liquid  injections.  Our  reasons  are  these:  the 
action  of  the  drug  is  a  protracted  one.  Almost  immediately 
after  its  introduction  into  the  fistula  there  is  formed  about  it 
an  almost  impermeable  layer  of  a  metallic  albuminate,  which 
effectively  prevents  further  rapid  action  of  the  caustic.  In 
addition  to  thus  preventing  further  action  of  the  dressing, 
this  combination  of  the  tissue  albumin  with  the  metal  of 
the  salt,  together  with  much  necrotic  tissue  that  it  has 
caused,  is  extremely  hard  to  remove  from  the  healthy  tissues. 
This  we  explain  by  pointing  out  that  the  action  of  the 
caustic,  prolonged  as  it  is,  sets  up  a  tissue  reaction  which 
partakes  largely  of  the  type  of  a  chronic  rather  than  an 
acute  inflammation.  With  a  chronic  inflammation  there  is 
sooner  a  tendency  to  the  production  of  fibrous  tissue  (and 
thus  the  firmer  attachment  of  the  necrosed  portions)  rather 
than  an  active  phagocytosis  and  the  casting-off  of  a  slough. 
Again,  careful  though  we  may  be  with  the  probe,  it  is 
extremely  difficult  to  be  certain  that  we  have  discovered  the 
whole  extent  of  any  fistula  An  equal  difficulty,  therefore, 
exists  in  being  certain  that  we  have  placed  the  caustic  in  the 
position  in  which  it  is  most  wanted.— namely,  at  the  further- 
most end  of  the  fistula  where  the  necrotic  tissue  is  to  be  found. 

\\  nen  a  caustic  is  used  at  all,  it  is  far  better  to  employ  it 
in  the  liquid  form,  when  either  of  the  drugs  we  have  just 
mentioned  may  again  be  used.  In  the  first  place,  the  liquid 
is  far  more  likely  to  be  brought  into  contact  with  the  diseased 
structures  than  is  the  solid  salt.  Also,  its  action  may  be 
regulated  by  altering  the  strength  of  the  solution,  and  the 
liability  to  form  impermeable  albuminates  thus  diminished 


348        DISEASES  OF  THE  HORSE'S  FOOT 

Probably  the  best  solution  for  use  in  this  way  is  the  old- 
fashioned  Villate's  solution  (see  p.  199). 

This  liquid  should  be  injected  at  least  every  day,  and,  in 
a  bad  case,  even  two  or  three  times  daily.  Practical  hints' 
to  be  borne  in  mind  when  attempting  to  cure  quittor  by 
means  of  injections  are  these: 

If  the  fistulas  are  numerous,  the  fluid  should  be  injected 
into  their  various  orifices. 

In  order  to  force  the  fluid  to  the  bottom  of  each  diseased 
track,  it  is  necessary,  when  injecting  one  opening,  to  firmly 
close  all  others. 

Several  injections  should  be  made  at  each  time  of  in- 
jection. In  other  words,  we  must  not  be  content  with  just 
forcing  fluid  in.  It  must  be  forced  in,  and  again  forced 
out  by  a  further  syringeful.  The  fistulous  tracks  must,  in 
fact,  be  washed  in  the  liquid. 

The  effect  of  the  injection  during  the  first  eight  or  ten 
days  is  to  render  suppuration  more  abundant  and  whiter. 
After  two  weeks  of  the  treatment  sloughing  of  the  inside  of 
the  sinuses  occurs,  and  healing  of  the  wound  commences. 
Signs  that  this  is  occurring  are — slight  haemorrhage  at  the 
end  of  each  injection,  and  a  gradually  increasing  difficulty 
in  forcing  in  the  fluid. 

The  Making  of  Counter-openings  to  the  Fistulas. — Although 
Villate's  solution  or  any  other  caustic  used  in  the  manner 
we  have  described  often  effects  a  cure,  many  practitioners 
insist  on  the  fact  that  a  counter-opening  to  the  fistula  must 
also  be  made. 

The  probe  is  used  and  the  direction  and  depth  of  the 
fistula  ascertained.  Through  the  wall  is  then  made  an 
opening  at  exactly  opposite  the  lowest  point  found  by  the 
probe,  or  through  the  sole  if  the  probe  should  there  lead  us. 
This  opening  is  best  made  with  a  sharp-pointed  iron,  and 
may  afterwards  be  kept  large  enough  by  an  occasional 
trimming  with  the  knife.  Many  of  the  older  authors,  and 
with  them  writers  of  the  present  day,  declare  that  unless  this 
is  done  the  ordinary  injection  is  likely  to  fail  in  a  great  many 
instances  where  it  would  otherwise  have  been  successful. 


DISEASES  OF  THE  LATERAL  CARTILAGES     349 

Where  a  counter-opening  is  thus  made  it  is  found  that  it 
very  readily  closes  with  granulation  tissue,  and  the  purpose 
for  which  it  was  made  defeated.  This  may  be  avoided  by 
the  use  of  a  seton.  In  preference  to  the  seton,  however,  we 
ourselves  would  advise  that  the  opening  be  kept  free  by  the 
occasional  use  of  a  sharp-edged  director  or  a  fine  scalpel. 

An  interesting  modification  of  the  practice  of  making 
a  counter-opening  is  that  related  by  Veterinary-Captain 
S.  M.  Smith.*  In  point  of  severity  it  runs  a  middle  course 
between  the  making  of  a  simple  counteropening  and  the 
removal  of  a  wedge-shaped  portion  of  the  coronary  band 
and  the  wall,  a  method  which  we  shall  later  describe. 

To  perform  this  operation,  the  animal  is  cast  and  chloro- 
formed. The  foot  is  fixed  and  the  parts  thoroughly  cleansed. 
The  horn  of  the  wall  is  then  sawed  through  in  a  direct  line 
from  the  coronary  margin  to  the  solar  edge,  the  saw-line 
running  exactly  over  the  seat  of  the  sinus. 

A  strong  scalpel  is  now  introduced  at  the  coronary  open- 
ing, with  its  cutting-edge  outwards,  and  is  gradually  passed 
down  the  opening  made  by  the  saw.  In  this  way  the  sinus 
is  completely  destroyed,  and  from  end  to  end  converted  into 
an  open  wound.  The  parts  are  then  washed  in  a  perchloride 
of  mercury  solution,  covered  with  a  mixture  of  powdered 
iodoform  and  boracic  acid,  over  which  a  pledget  of  carbolized 
tow  is  placed,  and  then  a  bandage  over  the  whole.  This 
dressing  should  be  left  on  three  or  four  days,  after  which 
the  injury  should  be  treated  as  an  ordinary  wound.  In 
conclusion,  the  author  says :  '  I  can  safely  recommend  this 
line  of  treatment  to  any  practitioner  having  an  obstinate 
case  under  treatment.' 

Removal  of  the  Wall  and  Excision  of  the  Necrotic  Tissue. 
— This  we  may  term  the  radical  operation  for  sub-horny 
quittor,  for  it  is  often  productive  of  a  successful  issue  when 
all  other  means  have  failed.  No  matter  in  what  position 
the  sinus  is,  whether  at  the  extreme  anterior  portion  of  the 
coronet,  or  whether  in  the  region  of  the  heels,  it  is  to  be 
thoroughly  opened  up.     To  do  this,  the  fistula  is  carefully 

*  Veterinary  Record,  vol.  ii.,  p.  157. 


350         DISEASES  OF  THE  HORSE'S  FOOT 

explored  with  the  probe  and  a  knowledge  of  its  exact 
dimensions  arrived  at.  This  is  carefully  noted,  and  the 
horn  of  the  wall  for  some  little  distance  around  it  then 
rasped  down  quite  thin.  Immediately  over  the  sinus,  and 
for  a  short  distance  on  either  side  of  it,  the  horn  is  stripped 
away  to  the  sensitive  structures.  The  cavity  of  the  fistula 
is  then  opened  up  with  a  scalpel,  and  every  particle  of 
diseased  tissue  removed  with  this  instrument  and  a  pair 
of  forceps.  After-dressing  consists  simply  in  the  application 
of  suitable  antiseptics. 

When  the  Complication  of  Necrosed  Tendon  or  Ligament 
exists. — We  may  take  it  as  an  axiom  that  wherever  this 
exists,  whether  it  is  in  the  extensor  pedis,  in  the  lateral 
ligaments  of  the  joint,  or  in  portions  of  the  flexor,  all 
diseased  structures  should,  where  possible,  be  removed.  This 
is  done  either  with  a  scalpel  or  with  a  curette. 

When  septic  matter  has  gained  the  sheath  of  the  perforans, 
and  the  formation  of  pus  therein  is  indicated  by  inflam- 
matory swellings  in  the  hollow  of  the  heel,  it  is  sometimes 
advisable  to  lay  the  sheath  open  for  1  to  2  inches  along  the 
course  of  the  tendons.  This,  if  a  fistula  is  present,  may  be 
best  done  with  a  blunt-pointed  bistoury,  or  with  a  cannulated 
director  and  a  scalpel.  With  the  pus  thus  given  exit,  and 
an  antiseptic  dressing  regularly  applied,  the  case  sometimes 
ends  in  rapid  resolution.  More  often  than  not,  however,  it 
is  found  that  the  pus  has  been  liberated  too  late,  and  that 
it  has  gravitated  in  the  sheath  to  the  extent  of  affecting  the 
plantar  aponeurosis.  Or  it  may  be,  of  course,  that  it  was  in 
the  plantar  aponeurosis  the  disease  commenced.  Whichever 
may  have  been  the  case,  we  have  in  the  hollow  of  the  heel 
one  or  more  fistulous  openings,  or  an  opening  we  have  made 
ourselves,  leading  down  to  a  necrosed  portion  of  the  terminal 
expansion  of  the  perforans. 

In  such  cases  we  ourselves  have  derived  benefit  from  a 
regular  flushing  of  the  sinuses  with  a  1  in  2,000  solution 
of  perchloride  of  mercury,  introduced  by  means  of  a  glass 
syringe,  followed  later  by  flushing  in  the  same  manner  with 
a  1  in  40  solution  of  carbolic  acid,  the  hollow  of  the  heel 


DISEASES  OF  THE  LATERAL  CARTILAGES     351 

meanwhile  being  kept  clean  with  an  antiseptic  pad  and 
bandage,  or  by  liberal  applications  of  an  antiseptic  powder. 

The  septic  materials  are  in  this  way  destroyed,  and  the 
wound  heals  without  further  complication.  We  must  admit, 
however,  that  the  cure  of  the  lesion  is  generally  at  the 
expense  of  slight  lameness,  due,  in  all  probability,  to  inflam- 
matory tissue  adhesions  between  the  flexor  perforans  and 
the  perforatus,  and  to  a  partial  destruction  of  the  synovial 
membrane  of  the  sheath. 

If,  in  spite  of  the  antiseptic  irrigations,  the  fistula  per- 
sists, then  nothing  remains  but  to  resort  to  excision  of  the 
aponeurosis,  as  described  on  p.  222. 

When  Necrosis  of  the  Lateral  Cartilage  is  present. — In 
this  case  we  may  at  first  try  the  ordinary  treatments  of 
poulticing  and  blistering,  of  antiseptic  caustic  injections,  and 
of  plugging.  In  some  cases  a  cure  is  effected.  Should 
these  fail,  however,  and  we  intend  to  see  the  finish  of  our 
case,  then  operative  measures  must  be  determined  on.  This 
means  cutting  down  upon  the  diseased  cartilage,  and  either 
removing  the  necrosed  portion,  or  excising  the  cartilage  in 
its  entirety. 

The  latter  method  is  seldom  practised  in  this  country. 
As  it  is  the  most  radical  of  the  two,  however,  we  shall 
describe  it  here  first. 

Extirpation  of  the  Lateral  Cartilage. — The  operation  of 
extirpating  the  lateral  cartilage  is  by  no  means  a  new  one, 
being  introduced,  according  to  Zundel,  by  the  senior 
Lafosse  in  1754.  It  consisted  in  removing  a  portion  of  the 
wall  by  grooving  and  stripping  it,  and  of  excising  the 
exposed  cartilage  by  means  of  a  sage-knife. 

As  to  what  portion  of,  and  how  much  of  the  horn  of,  the 
quarter  should  first  be  removed,  and  as  to  what  particular 
direction  each  groove  should  take,  opinion  among  the  older 
writers  varied  considerably.  This  we  know  now  is  not  an 
important  matter,  and  it  is  sufficient  to  say  that  the  first 
preliminary  is  a  thinning  down  of  the  horn  of  the  quarter 
with  the  rasp  over  the  position  occupied  by  the  cartilage. 

At  the  present  time  there  are  two  or  three  modifications 


352        DISEASES  OF  THE  HORSE'S  FOOT 

of  the  operation  as  originally  introduced.  In  all,  however, 
the  preliminary  steps  are  the  same.  We  shall  therefore 
describe  them  collectively,  as  applying  correctly  to  either  of 
the  three  methods  of  operating  we  are  about  to  show. 

Preparation  of  the  Subject  and  Preliminary  Steps  in  the 
Operation. — On  the  day  previous  to  the  operation  the  horn 
of  the  wall  immediately  over  the  cartilage  must  be  so 
thinned  with  a  rasp  as  to  yield  readily  to  pressure  of  the 
thumb  in  any  position.  It  should  be  so  thin  as  to  only 
just  avoid  wounding  the  sensitive  structures  below. 

The  whole  of  the  foot  must  then  be  thoroughly  cleansed, 
and  rendered  as  nearly  aseptic  as  possible.  The  use  of 
warm  water,  soap,  and  a  stiff  brush  is  the  readiest  means 
of  removing  the  surface  dirt.  Afterwards  the  foot  should 
be  soaked  for  some  time  in  a  reliable  antiseptic  solution, 
a  1  in  1,000  solution  of  perchloride  of  mercury  being 
the  most  suitable.  When  removed  from  the  solution  the 
foot  must  be  packed  round  with  wool  or  tow  impregnated 
with  corrosive  sublimate,  and  then  bandaged,  the  whole 
afterwards  wrapped  in  a  thick  cloth,  or  protected  with  a 
boot. 

On  the  following  day  the  animal  is  brought  out  and  cast, 
and  the  foot  desired  to  be  operated  on  firmly  secured,  after 
the  manner  described  on  p.  81.  The  bandages  and  subli- 
mate pads  are  then  removed,  and  the  skin  of  the  coronet 
over  the  seat  of  operation  shaved  of  hair.  An  Esmarch 
rubber  bandage  is  next  run  up  the  limb,  and  the  tourniquet 
applied,  thus  rendering  the  operation  a  nearly  bloodless  one. 

This  done,  the  animal  is  chloroformed,  and  an  antiseptic 
douche  played  over  the  foot. 

So  far,  the  steps  in  the  operation  are  common  to  all 
methods.  There  are  now,  however,  three  slightly  differing 
modes  of  extirpating  the  cartilage,  which  modes  vary  simply 
according  to  the  structures  severed  by  the  knife. 

First  Method. — This  is  the  oldest  method  of  the  three, 
and  consists  in  making  ( 1 )  a  horizontal  incision  through  the 
sensitive  laminae  along  the  lower  border  of  the  cartilage, 
and  (2)  a  vertical  incision  through  the  skin  of  the  coronet, 


DISEASES  OF  THE  LATERAL  CARTILAGES     353 

the  coronary  cushion,  and  a  portion  of  the  sensitive  laminae 
(see  Fig.  139). 

The  flaps  (Fig.  139,  a,  a)  are  now  held  back  by  tenaculse, 
and  the  whole  of  the  cartilage,  or  only  the  necrosed  portion, 
carefully  excised  by  means  of  right-  and  left-handed  sage- 
knives.  Fistulous  openings  in  either  of  the  flaps,  a,  a  must  now 
be  carefully  curetted  and  dressed,  and  the  flaps  allowed  to 


Fig.  139.— Excision  of  the  Lateral  Cartilage  (Old  Method). 

The  wall  covering  the  lateral  cartilage  first  thinned  and  stripped 
off;  the  two  flaps  (a,  a)  of  skin  and  the  coronary  cushion  made 
by  the  vertical  incision  turned  back. 

a,  The  operation  flaps ;  b,  the  exposed  cartilage ;  c,  the  sensitive 
laminae ;  d,  the  coronary  cushion. 

fall  into  position.  They  are  then  sutured  with  carbolized  gut, 
and  the  wound  finally  dressed  as  to  be  described  later  (p.  357) . 
Second  Method  (after  Moller  and  Frick*). — These 
operators  deem  it  wise  to  leave  untouched  the  skin  of  the 
coronet  and  the  coronary  cushion.     They  therefore  make 


*  Two  cases  of  quittor  successfully  treated  by  this  method  are 
reported  by  R.  Paine,  M.R.C.V.S.,  in  the  Journal  of  Comparative 
Pathology  and  Therapeutics,  vol.  xv.,  p.  8i. 


354  DISEASES  OF  THE  HORSES  FOOT 

their  first  incision  along  the  lower  border  of  the  coronary 
cushion  (see  Fig.  140),  afterwards  exposing  the  lower  half 
of  the  cartilage  by  removing  a  half-moon-shaped  portion  of 
the  thinned  horn  and  underlying  sensitive  laminae  (see 
Fig.  140,  b). 

This  done,  the  external  face  of  the  cartilage  is  separated 
from  the  skin  of  the  coronet.  To  do  this  a  double  sage- 
knife  is  run  flatwise  between  the  coronarv  cushion  and  the 


Fig.    140. — Excision    of    the    Lateral    Cartilage.     (After 
Moller    and    Frick.) 

a,  The  thinned  horny  wall  covering  the  coronary  cushion ;  b,  the 
lateral  cartilage  exposed  by  stripping  off  the  thinned  wall ;  c,  the 
sensitive  laminae. 

cartilage,  with  the  convex  surface  of  the  blade  towards  the 
skin.  The  knife  is  then  passed  backwards  and  forwards 
until  the  necessary  separation  is  accomplished.  During 
these  movements  of  the  knife  a  finger  of  the  unoccupied 
hand  should  follow  the  knife,  and  guard  the  coronary 
cushion   against   injury. 

Following  this,  the  inner  surface  of  the  cartilage  must  be 
also   separated   from   the  structures   lying  beneath   it.     To 


DISEASES  OF  THE  LATERAL  CARTILAGES    355 

this  end  a  sage-knife  (  right-  or  left-handed,  according  as  to 
whether  the  anterior  or  posterior  portion  of  the  cartilage  is 
to  be  first  removed )  is  again  passed  into  the  incision.  With 
the  cutting-edge  of  the  knife  forward,  it  is  gradually  reached 
round  and  under  the  hindermost  end  of  the  cartilage,  and 
the  posterior  half  of  the  cartilage  separated  from  underlying 
structures,  and  at  the  same  time  excised  by  one  clean  cut 
forwards.  Using  the  second  sage-knife  in  a  similar  man- 
ner, the  cutting-edge  this  time  backwards,  it  is  reached  in 
front  of  the  cartilage,  whose  anterior  half  is  then  excised 
by  a  careful  cut  backwards.  Any  small  portions  of  cartilage 
remaining  after  this  are  sought  for  with  the  finger,  and 
carefully  removed  by  means  of  a  scalpel  and  a  tenaculum. 

The  fistulous  opening  or  openings  in  the  skin  of  the 
coronet  should  now  be  thoroughly  curetted,  and  the  whole 
of  the  wound  dressed  as  to  be  described  later. 

In  removing  the  anterior  half  of  the  cartilage  it  is  highly 
important  to  remember  the  close  contiguity  to  it  of  the 
synovial  membrane  of  the  pedal  articulation.  This  projects 
as  a  small  sac  between  the  antero-  and  postero-lateral 
ligaments  of  the  joint.  Risks  of  injury  to  it  may  be 
diminished  by  having  the  foot  secured  with  a  line,  and 
pulled  forward  by  an  assistant  while  the  cut  is  being 
made. 

Third  Method  (after  Bayer). — This  operator  recom- 
mends that,  after  stripping  a  half-moon-shaped  piece  of 
horn  from  the  seat  of  operation,  instead  of  raising  the  skin 
of  the  coronet  and  the  attached  coronary  cushion  in  two 
flaps  (as  Fig.  139,  a,  a),  that  the  cartilage  be  exposed  by 
raising  up  one  flap  only  (Fig.  141,  a  ),  consisting  of  a  por- 
tion of  the  sensitive  laminae,  the  coronary  cushion,  and  the 
skin  and  underlying  structures  of  the  coronet. 

With  the  horse  cast  and  the  preliminary  steps  over,  the 
thinned  horn  of  the  quarter  is  incised  in  a  semicircular 
fashion,  and  the  half-moon-shaped  piece  thus  separated 
from  its  surroundings  stripped  off.  At  about  J  inch  from 
the  incision  in  the  horn,  a  second  incision  of  similar  shape 
is  made  through  the    sensitive    structures,    with    incision 


356        DISEASES  OF  THE  HORSE'S  FOOT 

is  also  carried  up  into  the  skin  and  structures  of  the 
coronet.  This  incision  severs,  from  bottom  to  the  top, 
( 1 )  the  sensitive  laminse  covering  a  portion  of  the  pedal 
bone  and  a  portion  of  the  lateral  cartilage,  (2)  the  coronary 
cushion,  and  (3)  the  skin  of  the  coronet  and  such  structures 
as  lie  between  it  and  the  cartilage. 

That  this  incision  of  the  sensitive  structures  should  be 
kept  at  J  inch  from  the  one  in  the  horn  has  a  reason.     It 


Fig.   141. — Excision  of  the  Lateral  Cartilage.    (After  Bayer.) 

The  horny  wall  is  stipped  off  over  the  seat  of  operation. 

a,  Semicircular  flap  of  sensitive  laminae,  coronary  cushion,  and  skin ; 
b,  the  Meral  cartilage;  c,  sensitive  laminae;  d,  the  coronary 
cushion. 

is  that  when  this  flap  is  again  placed  into  position  (as  later 
it  will  have  to  be)  we  have  round  its  circumferance  a  rim  of 
soft  structures  into  which  to  place  the  sutures.  And  in 
this  connection  it  is  well  to  advise  the  operator  that  the 
thinness  of  the  keratogenous  membrance  (the  laminal 
portion  of  it)  should  warn  him  that  the  portion  of  it  to  be 
turned  up — namely,  that  forming  the  tip  of  the  flap — should 
be  scraped  away  quite  close  to  the  os  pedis.      Unless  this  is 


DISEASES  OF  THE  LATERAL  CARTILAGES     357 

done,  there  will  not  be  a  sufficient  thickness  left  to  after- 
wards bring  into  position  and  suture. 

The  half-moon-shaped  piece  of  tissue  incised  is  now  care- 
fully dissected  away  from  the  external  face  of  the  cartilage, 
until  it  may  be  turned  up  as  a  flap  (see  Fig.  141,  a),  and 
held  from  off  the  cartilage  by  a  tenaculum. 

The  exposed  cartilage  is  now  carefully  removed  by  the 
aid  of  a  sage-knife  and  a  stout  pair  of  forceps,  the  same 
precaution  of  holding  the  foot  well  forward  being  again 
taken  in  order  to  avoid  wounding  of  the  articular  capsule. 

At  this  stage  in  the  operation  considerable  care  is  required. 
The  operator  must  remember  that  close  beneath  him,  and 
more  particularly  in  front,  is  the  pedal  articulation.  It  is 
better,  therefore,  to  excise  the  cartilage  piecemeal,  and  to  do 
it  carefully,  than  to  attempt,  at  the  risk  of  injury  to  the 
joint,  to  make  the  operation  '  showy.' 

During  removal  of  the  cartilage,  the  terminal  branches 
of  the  digital  arteries  are  wounded,  as  also  are  the  veins  of 
the  coronary  plexus.  Should  either  of  these  stand  out  with 
extra  prominence  from  the  others,  it  should  be  picked  up 
with  a  pair  of  forceps,  and  ligatured  with  either  carbolized 
gut  or  silk. 

Attention  should  then  be  given  to  the  flap  of  skin  and 
coronary  cushion.  Wherever  a  sinus  has  existed  in  it,  it  is 
to  be  carefully  scraped,  and  all  dead  portions  of  tissue 
removed.  This  done,  the  flap  is  allowed  to  fall  into  position, 
and  is  there  carefully  sutured,  not  only  at  the  skin  of  the 
coronet,  but  along  the  whole  circumference  of  the  incision. 

Dressing  of  the  Wound  and  After-Treatment. — The  whole 
secret  of  the  success  of  this  operation  is  in  afterwards 
maintaining  a  strict  asepsis  of  the  wound.  L^nless  there  is 
reasonable  room  for  belief  that  this  may  be  done,  the  opera- 
tion had  far  better  not  be  advised,  for  if  the  wound  is  after- 
wards suffered  to  get  into  a  suppurating  and  dirty  condition, 
the  last  stage  of  the  case  may  be  worse  than  the  first. 
Synovitis  and  arthritis,  with  certain  anchylosis  of  the  joint, 
and  a  probable  loss  of  our  patient,  is  almost  bound  to  follow. 

We  cannot,  therefore,  too  strongly  insist  upon  the  advice 


358        DISEASES  OF  THE  HORSE'S  FOOT 

that  the  whole  of  the  preliminary  antisepticising  of  the  foot 
that  we  have  described,  and  after  maintaining  of  asepsis 
that  we  are  now  about  to  relate,  must  be  methodically  and 
thoroughly  carried  out.  It  is  of  even  more  importance  than 
little  details  in  the  operation  itself. 

In  the  first  and  second  methods  of  operating,  directly 
the  actual  operation  is  over,  the  surface  of  the  wound  and 
both  surfaces  of  the  skin-flaps  should  first  be  thoroughly 
douched  with  a  1  in  1,000  solution  of  perchloride  of  mercury. 
Bayer  prefers  a  1  in  5  solution  of  idoform  in  ether. 

Next,  either  iodoform  or  chinosol  in  the  powder  should  be 
dusted  over  the  whole  surface,  including  again  both  inner 
and  outer  faces  of  the  reverted  skin-flaps.  This  done  the 
flaps  are  allowed  to  fall  into  position  and  sutured  there 
with  carbolized  silk  or  gut. 

Another  liberal  application  of  an  antiseptic  dressing 
follows  this.  Iodoform,  iodoform  and  boracic  acid,  or 
chinosol,  is  freely  dusted  over  the  wound  and  for  some 
distance  around  it.  Bayer,  however,  again  prefers  a  dress- 
ing of  the  wound,  and  especially  the  moistening  of  the  line 
of  sutures  with  the  1  in  5  solution  of  iodoform  in  ether. 

Over  the  wound  is  then  placed  a  protective  layer  of 
gauze,  impregnated  either  with  boric  acid,  with  a  mercuric 
salt,  or  with  iodoform. 

Finally,  numerous  small  and  lightly-rolled  balls  of  dry 
carbolized  tow  are  packed  regularly  over  the  whole  of  the 
operation  wound,  and  the  foot  bandaged. 

Practical  points  to  be  remembered  in  this  after-dressing 
are :  ( 1 )  The  balls*  of  tow  should  be  numerous  enough  to 
exercise  pressure  upon  the  sutured  flap  when  the  foot  is 
finally  bandaged.  (2)  The  bandage  should  be  run  on  from 
the  coronet  downwards,  in  order  to  insure  pressure  being 
exerted  in  the  exact  position  over  the  sutured  flap. 
(3)  Bandages   should   be   used  in   abundance,   commencing 

*  Bayer  recommends  that  the  tow  be  rolled  into  cylindrical  tam- 
pons, each  long  enough  to  cross  the  wound.  These  are  placed  on 
the  wound  in  alternate  horizontal  and  vertical  layers,  so  that  when 
rolled  round  by  a  bandage  they  are  pressed  into  an  even  and  com- 
pact pad. 


DISEASES  OF  THE  LATERAL  CARTILAGES     359 

always  from  the  coronet,  and  carefully  applied  so  as  to 
exert  an  even  and  uniform  pressure.  (4)  The  bandages 
should  be  of  clean,  unused  linen. 

Once  the  bandages  are  adjusted,  the  hobbles  may  be 
removed,  and  the  tourniquet  loosened.  Directly  the  tourni- 
quet is  removed  there  is  a  steady  oozing  of  blood  through 
the  bandages,  no  matter  how  many  we  have  put  on.  This 
should  occasion  no  alarm,  as  experience  has  taught  that  the 
careful  attention  to  antiseptic  measures  observed  through- 
out the  operation  has  the  effect  of  maintaining  the  lower- 
most dressings,  those  next  to  the  wound,  in  a  state  of 
asepsis.  The  bandaged  foot  should  now  be  wrapped  in 
a  piece  of  thick  clean  cloth  or  placed  in  a  boot. 

If  our  antiseptic  precautions  have  been  thorough,  the 
dressings  and  bandages  so  adjusted  may  be  allowed  to 
remain  without  disturbance  for  from  eight  to  fourteen  days. 
In  this,  however,  the  veterinary  surgeon  must  be  largely 
guided  by  the  symptoms  of  his  patient.  If,  at  the  end  of 
the  first  three  or  four  days,  the  animal  maintains  a  vigor- 
ous appetite,  if  he  commences  to  place  a  little  weight  on 
the  foot,  and  if  the  thermometer  gives  no  indication  of  a 
rise  beyond  the  one  or  two  degrees  of  ordinary  surgical 
fever,  then  the  surgeon  may  know  that  things  are  proceed- 
ing satisfactorily.  Pawing  movements  with  the  foot,  in- 
ability to  place  weight  upon  it,  loss  of  appetite,  an  increase 
in  the  number  of  respirations,  and  a  serious  rise  of  tem- 
perature, denote  the  opposite  state  of  affairs.  The  wound 
is  in  all  probability  suppurating.  The  bandages  and  dress- 
ings should  therefore  be  removed,  and  the  wound  either 
redressed  and  bandaged,  or  treated  as  an  ordinary  open 
wound. 

Ordinarily,  however,  if  the  operation  has  been  properly 
performed,  healing  takes  place  by  first  intention,  and  the 
wound  when  the  bandages  are  removed  at  the  end  of  the 
first  or  second  week  appears  clean  and  dry. 

Having  assured  ourselves  that  such  is  the  case,  we  dress 
the  foot  in  exactly  the  same  manner  as  before,  save  that 
so  many  bandages  are  not  put  on.     A  similar  dressing  is 


360        DISEASES  OF  THE  HORSE'S  FOOT 

repeated  weekly  until  such  time  as  the  wound  shows  suffi- 
cient growth  of  horn — quite  a  thin  pellicle — to  act  as  a 
protective.  It  may  then  be  left  undressed,  except  for  some 
simple  hoof  dressing  and  a  bandage. 

Complete  healing  of  the  wound  takes  from  about  four  to 
eight  weeks,  at  the  end  of  which  time  the  animal  can  be 
again  gradually  put  into  work.  The  labour,  however,  should 
be  light,  and  quite  three  or  four  months  should  be  allowed  to 
elapse  before  any  attempt  is  made  to  put  him  to  heavy  work. 

Should  the  second  method  of  operating  have  been  the 
one  adopted,  then  there  is  one  slight  difference  in  the  after- 
dressing  that  needs  attention  calling  to  it.  In  this  case  we 
have  more  or  less  of  a  hidden  cavity  left  to  deal  with  rather 
than  the  broad  and  open  wound  left  in  either  of  the  other 
methods.  This  cavity,  left  by  the  extirpation  of  the  carti- 
lage, must  be  thoroughly  dressed  with  iodoform  or  chinosol, 
or  with  Bayer's  iodoform  in  ether.  The  packing  with  car- 
bolized  tow  and  the  bandaging  may  then  be  proceeded  with 
as  before. 

In  conclusion,  we  may  say  that  the  operation  is  one  of 
some  delicacy,  and  needs  a  good  surgeon  for  its  successful 
performance.  Furthermore,  no  one  of  the  antiseptic  pre- 
cautions we  have  advised  can  be  omitted.  It  is,  perhaps, 
these  two  considerations  (and  in  justice  to  the  English 
surgeon  we  should  say  most  probably  the  latter  of  them) 
that  have  prevented  this  operation  from  being  generally 
adopted. 

That  it  is  successful  there  is  no  gainsaying.  Professor 
Bayer,  of  the  Vienna  School,  with  whose  name  is  associated 
the  last  of  the  three  methods  of  operating  we  have  described, 
is  enthusiastic  in  praise  of  the  operation,  and  says :  '  The 
favourable  results  that  I  have  got  by  this  operation  have 
caused  me  wholly  to  abandon  the  medicinal  treatment,  and 
to  prefer  in  all  cases  the  surgical  operation  as  being  the 
best  means  to  the  end.' 

Partial  Excision  of  the  Lateral  Cartilage. — Discarding 
the  somewhat  elaborate  methods  we  have  just  described, 
there    are    English   operators    who    removed    the   necrosed 


DISEASES  OF  THE  LATERAL  CARTILAGES     361 

only  of  the  cartilage,  and  do  so  in  what  appears  at  first 
sight  a  comparatively  rough-and-ready  manner. 

The  apparent  roughness  is  that  they  do  not  concern 
themselves  with  conserving  the  coronary  cushion,  and 
hesitate  but  little  in  cutting  portions  of  it  bodily  away. 
One  would  imagine  that  in  this  case  the  quarter  of  the  side 
operated  on  would  be  always  more  or  less  bare  of  horn. 
Such,  however,  is  not  the  case. 

To  perform  this  operation  the  animal  is  again  cast  and 
chloroformed.  Some  operators,  however,  use  the  stocks 
and  dispense  with  the  anaesthetic.  The  foot  is  first  well 
cleaned  with  soap  and  water  and  a  stiff  brush,  and  the  hair 
of  the  coronet  over  the  seat  of  operation  shaved.  Again, 
too,  the  horn  of  the  affected  quarter  is  rasped  until  it  yields 
easily  to  pressure  of  the  thumb,  and  the  whole  of  the  foot 
washed  in  an  antiseptic  solution. 

A  probe  is  now  inserted  into  the  opening  at  the  coronet, 
and  the  direction  of  the  fistula  noted,  after  which  the  foot 
is  firmly  secured,  and  an  Esmarch  bandage  and  tourniquet 
applied  to  the  limb. 

This  done,  a  triangular  or  wedge-shaped  portion  of  skin, 
coronary  cushion,  and  thinned  horn  is  removed  with  a 
strong  sage-knife  or  scalpel. 

The  base  of  the  wedge-shaped  portion  removed  contains 
the  opening  of  the  fistula,  and  the  apex  of  the  wedge  should 
reach  to  the  bottom  of  the  sinus   (see  Fig.  142). 

After  the  horn  is  removed  and  the  fistula  followed  up,  it 
is  sometimes  found  that  what  we  at  first  thought  was  its 
end,  it  may  now  be  continued  in  an  altogether  different 
direction. 

It  is  again  followed  up  with  the  probe,  and  the  horn  and 
sensitive  structures  excised  until  we  are  quite  certain  we 
have  reached  its  furthest  extent. 

Attention  should  next  be  paid  to  the  cartilage.  Where- 
ever  spots  of  necrosis  are  found,  as  indicated  by  the  pea- 
green  colour  of  the  affected  parts,  they  must  be  carefully 
excised.  Care  should  be  taken  in  so  doing  to  carry  the  line 
of  excision  some  little  distance  around  the  visibly  affected 


362        DISEASES  OF  THE  HORSE'S  FOOT 

parts.  This  is  done  that  we  may  be  quite  certain  nothing 
at  all  remains  calculated  to  give  rise  to  further  trouble. 

It  goes  without  saying  that,  in  addition  to  the  necrosed 
cartilage,  all  other  diseased  and  necrotic  tissues  should  also 
be  removed.  The  os  pedis  is  occasionally  found  necrotic 
just  where  the  cartilage  joins  it,  or  it  may  be  that  a  small 
portion  of  the  sensitive  laminae,  by  reason  of  its  liver- 
red  or  even  gray  coloration,  gives  evidence  of  death  of 
the  part. 

The  former  must  be  well  curetted,  and  the  latter  cleansed 
carefully  with  a  scalpel  and  forceps. 


Fig.   142. — Partial   Excision  of   the    Lateral    Cartilage   by 
removing  a  Portion  of  the  Coronary  Cushion. 

The  dotted  lines  show  the  outline  of  the  wedge-shaped  portion  of 
structures  to  be  removed,  including  skin,  coronary  cushion, 
horn,  and  sensitive  lamina?. 

a,  The  opening  of  the  fistula. 

The  operation  finished,  the  foot  is  again  douched  in  an 
antiseptic  solution,  the  wound  mopped  dry  with  carbolized 
tow,  dressed  with  either  of  the  dressings  described  on 
page  358,  and  finally  bandaged.  The  dressing  should  be 
changed  every  three  days  only,  unless  in  the  meanwhile 
pawing  movements  and  other  symptoms  of  distress  indicate 
their  removal. 

The  length  of  coronary  cushion  removed  in  this  operation 
is  from  J  to  i  inch  (we  ourselves,  however,  have  seen  it 
more),  and  yet  its  loss  seems  to  occasion  no  serious  after- 


DISEASES  OF  THE  LATERAL  CARTILAGES  363 

trouble  beyond  a  slight  deformity  of  the  parts  beneath. 
The  sensitive  structures  become  sufficiently  covered  with 
horn,  and  the  animal  in  nearly  every  case  is  returned  to 
work,  while  in  a  great  many  instances  he  may  also  trot  per- 
fectly sound. 

Simple  though  the  operation  may  appear,  and  apparently 
rough  in  its  method,  it  is  nevertheless  successful  in  effecting 
a  cure  in  cases  where  blisters,  plugging,  injections,  and 
other  means  have  failed. 

Mr.  W.  Dacre.  M.R.C.V.S.,*  after  reading  an  article  on 
the  operation  before  the  members  of  the  Lancashire 
Veterinary  Medical  Association,  says:  '  My  observations 
have  not  been  based  on  a  single  case,  and  having  had  nine 
of  them,  and  all  of  them  successful,  I  felt  it  to  be  my  duty 
to  bring  this  subject  before  the  Society.' 

Mr.  T.  W.  Thompson,  M.R.C.V.S.,"*"  says:  'In  a  great 
number  of  cases  I  have  removed  a  J  inch  of  the  coronary 
band.  ...  I  have  performed  the  operation  a  great  number 
of  times,  and  have  never  seen  a  foot  that  has  been  damaged 
by  it.' 

Professor  Macqueen  $  says :  '  I  do  not  spare  the  coronary 
band  or  sensitive  laminae  when  I  find  those  parts  diseased. 
I  do  not  unnecessarily  damage  those  structures.  At  the 
same  time,  I  am  confident  that  excision  of  a  piece  of  the 
coronary  band  or  removal  of  a  few  sensitive  laminae  has 
not  the  untoward  consequences  so  much  dreaded  in  former 
days.' 

Mr.  John  Davidson,  M.R.C.V.S..§  says  :  '  The  treatment 
described,  if  carefully  carried  out  and  details  attended  to, 
will  be  found  a  success  in  dealing  with  the  majority  of 
cases  of  quittor.  If  I  may  be  permitted  to  say  so.  without 
being  considered  boastful,  I  have  yet  to  see  the  first  case 
that  has  resisted  the  treatment.' 

Should  our  case  of  quittor  be  complicated  by  caries  of 
the  bone,  this  must,  where  possible,  be  scraped  or  curetted 

*  Veterinary   Record,   vol.    v.,    p.    407. 
t  Ibid.  t   Ibid.,  p.  714. 

§  Ibid.,  vol.,  xiv.,  p.  769. 


364        DISEASES  OF  THE  HORSE'S  FOOT 

until  the  whole  of  the  diseased  portion  is  removed,  and  a 
healthy  surface  is  felt.  After-dressing  must  then  be  carried 
out  as  in  other  cases. 

The  treatment  of  ossified  cartilage  will  be  found  under 
treatment  of  side-bones,  and  the  methods  of  dealing  with 
penetrated  articulation  and  purulent  arthritis  are  treated 
of  in  Chapter  XII. 

;,  Surgical  Shoeing  in  Quittor. — In  the  case  of  simple  or 
cutaneous  quittor,  no  alteration  in  the  shoeing  is  necessary. 

When  the  condition  becomes  sub-horny,  however,  and 
particularly  when  it  is  situated  in  the  region  of  the  quarters, 
ease  is  afforded  to  the  diseased  parts  by  removing  the  bear- 
ing of  the  shoe  in  that  position. 

Should  there  be  no  dependent  opening  at  the  sole, 
then  the  best  shoe  for  the  purpose  is  an  ordinary  bar 
shoe  (Fig.  68),  with  the  bearing  eased  under  the  affected 
quarter. 

If,  however,  there  is  a  dependent  orifice,  or  one  is  ex- 
pected, then  it  will  be  necessary  either  to  leave  the  animal 
unshod  or  to  provide  him  with  a  shoe  that  admits  of  dress- 
ing the  lesion.  In  the  latter  case  the  most  suitable  shoe  will 
be  found  to  be  either  a  three-quarter  shoe  (Fig.  102)  or  a 
three-quarter  bar  shoe  (Fig.  103).  Many  operators,  how- 
ever, keep  the  animal  unshod.  We  must  say  ourselves  that 
we  consider  a  shoe  useful  after  either  of  the  operations 
for  removal  of  the  cartilage,  if  only  to  assist  in  maintaining 
the  bandages  and  dressings  in  position. 

In  this  case  a  very  useful  shoe  will  be  the  three-quarter 
bar  shoe.  With  a  little  manipulation  the  bandages  are 
easily  run  under  the  bar  portion  of  the  shoe,  and  a  few  of 
their  turns  every  now  and  again  wrapped  round  the  bar  in 
order  to  keep  the  whole  firmly  in  position. 

In  connection  with  tendinous  quittor,  when  septic  matter 
has  gained  the  sheath  of  the  flexor  tendons,  there  is,  for  a 
long  time  after  healing  of  the  fistula,  a  marked  tendency 
for  the  animal  to  go  on  his  toe.  To  a  large  extent  we 
judge  this  to  be  due  to  slight  adhesions  between  the  two 
tendons    brought    about    by    the    growth    of    inflammatory 


DISEASES  OF  THE  LATERAL  CARTILAGES  365 

fibrous  tissue.  Tn  such  cases  benefit  is  sometimes  derived 
from  the  application  of  a  shoe  with  an  extended  toe-piece 
(  see  Figs.  84  and  108). 


C.    OSSIFICATION  OF  THE  LATERAL  CARTILAGES,  OR 
SIDE-BONES. 

Definition. — An  abnormal  condition  of  the  lateral  carti- 
lages, in  which  the  substance  of  the  cartilage  becomes 
gradually  removed  and  bone  formed  in  its  place. 


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Fig.    143. — Ossified    Lateral    Cartilages    (Side-bones). 

Symptoms  and  Diagnosis. — Side-bones  are  nearly  always 
met  with  in  heavy  draught  animals,  and  are  rarely  seen  in 
the  feet  of  nags.  They  are,  moreover,  nearly  always  con- 
fined to  the  fore-feet.  In  the  ordinary  way  little  need  be 
Sc.id  concerning  their  characteristics,  and  the  way  in  which 
they  may  be  detected.  Xeither  need  any  concern  be 
ordinarily  manifested  wtih  regard  to  the  effect  they  may 
have  on  the  animal's  gait  and  future  usefulness.  Seeing, 
however,  that  side-bone  constitutes  one  of  the  recognised 
hereditary  diseases,  and  that  at  the  various  agricultural 
and  horse   shows   its   existence   or   otherwise   in   a  certain 


366        DISEASES  OF  THE  HORSE'S  FOOT 

animal  is  a  matter  of  great  importance,  some  little  attention 
must  be  given  to  these  two  points. 

With  a  side-bone  anywhere  approaching  full  develop- 
ment, diagnosis  is  easy.  The  thumb  is  pressed  into  the 
coronet  over  the  seat  of  the  cartilage,  when,  in  place  of  the 
elasticity  we  should  normally  meet  with,  we  have  the  solid 
resistance  offered  by  bone.  In  some  instances  diagnosis  is 
even  easier  still.  We  refer  to  those  cases  in  which  the 
side-bone  stands  above  the  level  of  the  coronet  with  such 
prominence  as  to  be  readily  seen  and  recognised  without 
manipulation,  and  where  its  growth  has  caused  distinct 
enlargement  and  bulging  of  the  wall  of  the  affected  quarter. 
It  seems  that  in  such  cases  the  bone-forming  process  does 
not  end  with  simply  depositing  bone  in  place  of  the  removed 
cartilage,  but  that,  after  that  is  accomplished,  the  bone  still 
continues  to  be  produced,  as  in  the  case  of  an  exostosis 
elsewhere. 

Although  diagnosis  in  cases  such  as  these  is  easy,  it 
becomes  a  very  different  matter  when  we  are  called  upon 
to  give  an  opinion  in  cases  where  ossification  of  the  carti- 
lage is  only  just  commencing.  Whether  the  result  of  our 
examination  is  to  decide  the  sale  or  purchase  of  an  animal, 
to  determine  his  fitness  or  otherwise  to  enter  the  show- 
ring,  or  to  merely  advise  a  client  as  to  whether  or  no  a 
side-bone  is  in  course  of  formation,  our  position  is  equally 
difficult,  and  in  either  case  our  examination  must  be 
searching. 

Perhaps  the  best  advice  we  can  give  is  to  say  that  the 
whole  of  the  cartilage  must  be  manipulated  both  with  the 
foot  oh 'and  off  the  ground.  What  the  reason  may  be  we 
do  not  pretend  to  say,  but  it  is  a  well-known  fact  that  in 
many  instances  the  cartilage,  with  the  foot  bearing  weight, 
i?  so  rigid  as  to  at  once  convey  the  impression  that  ossifica- 
tion has  commenced  or  is  even  far  advanced.  And  yet 
that  same  cartilage,  with  the  foot  removed  from  the  ground, 
is  as  pleasantly  yielding  to  pressure  of  the  thumb  as  the 
most  exacting  of  us  could  wish  for.  In  any  case,  then, 
where  doubt  exists,  the  foot  should  be  lifted  to  the  knee, 


DISEASES  OF  THE  LATERAL  CARTILAGES  367 

and  the  cartilage  carefully  examined  with  the  foot  in  that 
position.  If,  then,  at  any  spot  above  the  normal  contour 
of  the  os  pedis  we  meet  with  hardness  or  rigidity,  we  are 
to  look  upon  that  foot  with  suspicion.  Nevertheless,  pro- 
viding our  conscience  is  sufficiently  elastic,  the  animal  may 
be  passed  sound  so  far  as  the  existence  of  a  side-bone  is 
concerned.  We  know,  however,  that  with  commencing 
rigidity  we  may  ere  long  expect  one,  and  if  our  opinion  is 
asked  with  regard  to  that  particular,  it  must  be  admitted 
that  with  rigidity  of  the  cartilage  once  commenced  it  is 
usually  not  long  afterwards  before  a  fully-developed  side- 
bone  makes  its  appearance. 

As  is  only  to  be  expected,  the  first  noticeable  hardening 
of  the  cartilage  is  to  be  found  near  the  normal  bone.  We 
may  thus  look  for  it  more  particularly  in  the  lower  portions 
of  the  cartilage.  We  think  we  may  say,  too,  that  in  the 
vast  majority  of  cases  the  ossification  of  the  cartilage  com- 
mences in  its  anterior  half.  It  is  thus  brought  about  that 
often  we  are  called  upon  to  examine  and  report  on  the 
condition  when  we  have  anteriorly  a  side-bone  in  course  of 
formation,  and  posteriorly  a  perfectly  normal  cartilage.  It 
is  to  the  latter  half  of  the  cartilage  that  dealers  and  others 
mainly,  if  not  wholly,  devote  their  attention.  A  horse  with 
the  cartilage  in  this  transition  state  will  therefore  pass 
muster,  and  a  nice  little  point  of  ethics  has  again  to  be 
decided  by  the  veterinary  surgeon  before  giving  his  sig- 
nature to  a  certificate  of  examination  of  an  animal  in  this 
condition. 

With  regard  to  alteration  in  gait,  we  may  say  at  once 
that  side-bones  in  heavy  animals  are  not  often  the  cause  of 
lameness.  In  fact,  where  the  foot  is  well  developed,  when 
neither  the  foot  as  a  whole  nor  the  phalangeal  bones  give 
evidence  of  disease,  and  where  the  pasterns  are  fairly 
oblique  and  well  formed,  this  alteration  of  the  cartilages 
may  be  looked  upon  as  of  no  serious  import  at  all.  Neither 
is  the  side-bone  due  to  blows  or  other  injuries  likely  to  be 
productive  of  lameness — that  is,  always  supposing,  of 
course,  that  the  foot  in  other  respects  is  of  good  shape. 


368        DISEASES  OF  THE  HORSE'S  FOOT 

If  lameness  is  met  with  at  all,  then  it  is  where  we  have 
a  foot  that  is  in  other  respects  unsound,  with  badly  con- 
tracted heels  and  upright  '  stumpy  '  hoof,  or  where  side- 
bones  have  occurred  in  a  young  animal,  and  have  already 
reached  a  large  size  before  the  horse  is  put  to  labour.  In 
this  latter  case,  the  added  effects  of  concussion  and  the 
evil  influences  of  shoeing  are  sufficient  to  turn  the  scale. 
Directly  the  animal,  previously  sound,  is  asked  to  work, 
lameness  is  the  result. 

It  follows,  therefore,  that  side-bone  in  the  feet  of  young 
animals  is  of  far  more  serious  import  than  when  occurring 
in  older  horses.  In  a  nag  animal  they  constitute  a  positive 
unsoundness,  and  lameness  in  this  case  is  more  often  than 
not  an  accompanying  symptom. 

Causes. — To  commence  with,  we  may  remark  that, 
although  met  with  sometimes  in  very  early  life,  side-bones 
are  seldom,  if  ever,  congenital,  and  that  more  often  than 
rot  they  may  be  looked  for  in  animals  of  three  years  old, 
or  older — seldom  earlier.  They  appear,  in  fact,  only  when 
the  animal  is  shod  and  commences  work. 

This  at  once  suggests  two  of  the  principal  factors  in  their 
causation — namely,  concussion  and  loss  of  normal  function. 
Directly  the  horse  is  put  to  work  he  has  for  a  great  part  of 
his  time  to  travel  upon  roadways — either  macadamized 
roads  or  town  sets — where  everything  is  calculated  to  bring 
concussion  about.  In  addition  to  that  he  has  the  lateral 
cartilage  itself  thrown  largely  out  of  action  by  shoeing. 
We  explained  in  Chapter  III.  (p.  66)  that  the  chief  function 
of  the  cartilage  was  to  take  concussion  received  by  the 
plantar  cushion  and  direct  the  greater  part  of  it  outwards 
and  backwards.  Now,  with  the  animal  shod,  the  plantar 
cushion  does  not  itself,  as  normally  it  should,  receive  con- 
cussion. By  the  shoeing  the  frog  is  lifted  from  the  ground, 
and  the  plantar  cushion,  together  with  the  cartilage,  taken 
largely  out  of  active  work.  In  other  words,  the  normal 
outward  and  inward  movements  of  the  cartilage  are  enor- 
mously reduced. 

It  is  fair,  we  think,  to  take  it  that  the  mere  fact  of  the 


DISEASES  OF  THE  LATERAL  CARTILAGES  369 

lateral  cartilage  persisting  as  cartilage  is  due  in  large 
measure  to  its  constant  movement.  Directly,  therefore, 
it  is  placed  in  a  state  of  comparative  idleness,  then  it  com- 
mences to  ossify,  more  particularly  if  there  should  at  the 
same  time  be  a  tendency  to  a  low  type  of  inflammation  of 
the  parts. 

Does  this  latter  exist?  We  may  safely  say  that  it  does. 
It  is  in  this  way :  The  secondary  effect  of  loss  of  ground- 
pressure  upon  the  frog  and  plantar  cushion  is  to  bring 
about  contraction  of  the  heels.  With  this  we  get  compres- 
sion of  the  parts  within,  with  a  certain  amount  of  irritation 
and  the  exact  low  type  of  inflammatory  phenomena  calcu- 
lated to  assist  in  the  bone-forming  process. 

The  fact  that  concussion  acts  as  a  cause  explains  in  great 
measure  how  it  is  that  side-bones  are  more  frequent  in  cart 
animals  than  in  nags,  and  also  why  they  should  be  more 
common  in  the  fore- feet  than  in  the  hind.  Taking,  in  both 
animals,  a  rough  calculation  as  to  the  weight  of  body 
carried  by  feet  of  a  certain  size,  we  notice  at  once  that  the 
cart  animal  has  proportionately  more  weight  to  carry  than 
has  the  nag.  Concussion  to  the  foot  is  therefore  greater. 
The  greater  part  of  the  body-weight  is  born  by  the  fore- 
limbs.  Concussion  is  therefore  greater  to  the  fore-feet  than 
to  the  hind. 

This,  however,  does  not  explain  altogether  the  compara- 
tive immunity  of  the  nag  animal  from  this  defect.  He,  too, 
must  also  be  subject  to  the  effects  of  concussion,  especially 
when  his  higher  and  faster  action  is  taken  into  account. 
To  our  minds  there  is  only  one  explanation  to  be  offered 
here.  We  point  at  once  to  the  years  of  constant  and 
judicious  breeding  of  the  nag.  Compare  that  with  the 
relatively  few  minutes  that  have  been  devoted  to  a  more 
careful  selection  of  the  cart  animal,  and  we  at  once  see  a 
possible  explanation.  That  the  explanation  holds  some 
amount  of  truth  is  borne  out  by  the  fact  that,  since  a  greater 
attention  has  been  paid  to  the  selection  of  our  cart  animals, 
side-bone  has  grown  a  great  deal  less  common. 

Is  side-bone  hereditarv?     We   can  best  answer  that  bv 


370        DISEASES  OF  THE  HORSE'S  FOOT 

saying  that,  some  several  years  ago,  the  Council  of  the 
Royal  College  of  Veterinary  Surgeons,  at  the  request  of  the 
Royal  Commission  on  Horse  Breeding,  drew  up  a  list  of 
those  diseases  '  which  by  heredity  rendered  stallions  so 
affected  unfit  as  breeding  sires,'  and  that  in  that  list  was 
included  side-bone. 

Side-bones,  therefore,  are  hereditary.  We  think,  how- 
ever, the  statement  needs  qualifying.  It  is  in  this  way: 
s'de-bones  occur  only  at  a  certain,  usually  well-defined,  time 
after  birth,  and  we  might  say  are  never  congenital.  They 
occur  only  after  the  animal  has  been  put  to  work,  and  are 
more  or  less  plainly  due  to  mechanical  causes — namely,  the 
ill  effects  of  shoeing  and  concussion.  The  cause  of  their 
appearance,  in  short,  is  more  plainly  extrinsic  than  intrinsic, 
and  side-bone  in  the  horse  is,  as  Professor  McGill  puts  it, 
about  as  much  due  to  heredity  as  is  corn  on  the  human  foot. 

Between  these  two  opinions  —  that  they  are  plainly 
hereditary,  and  that  they  just  as  plainly  are  not — it  is  well 
to  strike  a  middle  course.  They  are,  we  will  say,  heredi- 
tary in  this  way :  So  long  as  a  cart  animal  is  bred,  to  put  it 
vulgarly,  '  top-heavy  '  (that  is,  with  a  body  out  of  reason- 
able proportion  to  the  feet  that  have  it  to  support),  so  long 
will  the  foot  be  subjected  to  a  greater  concussion,  and  so 
long  will  side-bones  in  such  animals  commence  to  make 
their  appearance  at  about  middle  life. 

In  addition  to  the  causes  we  have  now  mentioned,  side- 
bones  are  often  the  result  of  other  diseases  of  the  foot. 
They  thus  occur  as  a  sequel  to  sub-horny  quittor,  to  sup- 
purating corn,  to  complicated  quarter  sand-crack,  or  to  the 
inflammation  of  the  parts  occasioned  by  a  prick.  They  also 
arise  in  many  instances  from  the  effect  of  a  prick  or  injury 
to  the  coronet.  Among  the  latter  we  may  mention  treads 
from  other  animals,  and  treads  inflicted  by  the  animal  him- 
self with  the  calkin  of  an  opposite  shoe,  or  the  repeated  in- 
jury occasioned  by  the  shafts  being  carelessly  allowed  to 
drop  on  to  the  foot.  In  severe  cases  of  laminitis,  too,  the 
cartilages  are  nearly  always  affected.  In  this  instance  the 
inflammatory  phenomena  in  the  os  pedis  no  doubt  give  rise 


DISEASES  OF  THE  LATERAL  CARTILAGES  371 

to  an  abnormal  activity  of  bone-forming  cells.  The  cartilage 
is  invaded,  and  the  side-bone  formed  (see  Fig.  118). 

Treatment. — In  the  ordinary  way  the  '  treatment '  of  side- 
bone  is  a  thing  but  rarely  mentioned.  The  explanation 
lies,  of  course,  in  the  fact  that  side-bones  are  so  rarely  the 
cause  of  lameness.  When  lameness  does  occur  with  a  side- 
bone,  and  we  have  reason  to  believe  that  the  said  side-bone 
is  the  cause  of  the  lameness,  it  is  well  before  talking  of 
treatment  to  question  ourselves  thus  :  Tn  what  w^ay  does 
the  side-bone  cause  lameness  ?'  The  now  generally-accepted 
answer  to  that  query  is  the  explanation  put  forward  several 
years  ago  by  Colonel  Fred  Smith — namely,  that  the  pain, 
and  therefore  the  lameness,  was  due  to  the  compression  of 
the  sensitive  laminae  between  the  ossified  and  enlarged 
cartilage  and  the  non-yielding  and  often  contracted  wall  of 
the  quarters.  That,  in  fact,  constitutes  the  basis  upon 
which  Smith's  operation  for  side-bone  (that  of  grooving  the 
wall  of  the  quarters  )  is  founded. 

Before  describing  the  operation,  however,  we  may  say 
that  we  are  now  able  to  understand  that  older  operators 
who  claimed  success  for  other  methods  of  treatment,  were 
to  a  very  great  extent  justified  in  so  doing. 

For  instance,  take  the  combined  treatments  of  firing  and 
blistering,  and  the  use  of  a  bar  shoe.  Here  the  beneficial 
action  of  the  cautery  and  the  blister  may  be  largely  prob- 
lematical. The  bar  shoe,  however,  would  be  almost  certain 
to  give  good  results.  Frog-pressure  with  the  ground  would 
be  again  restored,  and  the  contraction  of  the  heels  removed. 
Pinching  of  the  sensitive  structures  would  be  diminished, 
and  the  lameness  cured. 

Take,  again,  the  treatment  of  '  unsoling.'  It  was  bar- 
barous, we  know — barbarous,  because  unnecessary  and 
easily  avoidable.  It  was  practised,  however,  certainly  very 
little  more  than  two  decades  ago,  and  practised  by  men  of 
standing  in  the  profession.  Without  dragging  the  case  to 
light  again  by  mentioning  the  names  of  those  concerned, 
we  may  mention  that  not  many  years  ago  a  highly  respected 
member  of  the   profession  was,  at  the   instigation   of   the 


372        DISEASES  OF  THE  HORSE'S  FOOT 

Royal  Society  for  the  Prevention  of  Cruelty  to  Animals, 
prosecuted  for  practising  unsoling  for  the  relief  of  side- 
bone.  Practically  only  one  other  member  of  the  profession 
was  able  to  come  forward  and  defend  the  operation  on  the 
score  of  its  utility.  Wc  see  now,  however,  that — as  does. 
Smith's  operation — unsoling  does  permit  of  the  greater  ex- 
pansion of  the  heels.  The  contraction  is  done  away  with, 
the  pressure  on  the  sensitive  lamime  again  diminished,  and 
the  lameness  relieved. 

Not  that  we  are  attempting  to  defend  the  operation — far 
from  it.  We  simply  mention  it  as  interesting,  and  quote 
this  and  the  use  of  the  bar  shoe  (with  both  of  which 
methods  older  operators  have  claimed  success  )  merely  as 
evidence  that  the  operation  of  Smith  is  based  on  a  logical 
foundation. 

When  treatment  is  decided  on,  therefore,  we  may  first 
advise  blistering  and  the  use  of  a  bar  shoe.  After  that, 
should  the  lameness  continue,  and  should  we  still  judge 
the  side-bone  to  be  the  cause  of  it,  the  operation  may  be 
advised. 

As  we  have  said  before,  the  operation  consists  in  so 
grooving  the  wall  as  to  allow  of  the  quarters  widening  suffi- 
ciently to  relieve  pressure  on  the  parts  within.  In  one  or 
two  previous  portions  of  this  work  we  have  considered 
operations  involving  this  procedure.  Before  detailing  the 
operation  here,  therefore,  we  will  first  describe  the  instru- 
ments necessary,  and  the  most  satisfactory  methods  of 
incising  the  horn. 

To  begin  with,  it  must  be  remembered  that  all  methods 
of  hoof  section  have  for  their  objects  the  after-expansion  of 
the  horny  box,  and  that  this  can  only  be  brought  about  by 
making  each  groove  complete  from  coronary  margin  to  solar 
edge  of  the  wall,  and  carrying  it,  throughout  its  length, 
deep  enough  to  reach  the  commencement  of  the  sensitive 
structures. 

To  this  end,  therefore,  the  operator  must  bear  in  mind 
the  comparative  thickness  of  the  various  parts  of  the  wall, 
and  must,  in  particular,  remember  the  relative  thinness  of 


DISEASES  OF  THE  LATERAL  CARTILAGES  373 

that  portion  of  horn  forming  the  outer  boundary  of  the 
cutigeral  groove,  and  accommodating  the  coronary  cushion. 
For  the  making  of  the  incisions  there  is  the  special  saw- 
devised  for  this  operation  by  Colonel  F.  Smith,  A.V.D.,  and 
which  we  illustrate  in  Fig.  144.  With  this  the  wall  is  sawn 
through  until  the  depth  arrived  at  is  equal  to  what  is  indi- 
cated by  a  previous  examination  of  the  thickness  of  the  crust 
as  viezved  from  the  solar  surface.  Here  Colonel  Smith  says: 
4  I  strongly  advise  everyone  to  use  a  metal  gauge  (  a  thin 
piece  of  material )  to  introduce  into  the  incision  made  by  the 
saw,  and  run  it  up  and  down  to  ascertain  whether  the  wall 
is  properly  divided  throughout.  The  depth  to  which  this 
should  be  done  we  know  from  the  previous  measurements 
of  our  gauge  on  the  crust.' 


Fig.    144.— Smith's    Side-bone    Saw    (Early    Pattern). 

Should  the  saw  be  of  a  pattern  in  which  the  set  of  its 
teeth  makes  only  a  narrow  incision,*  it  should,  while  opera- 
ting, be  kept  wrell  oiled,  and  should  be  withdrawn  every  few- 
seconds  in  order  that  the  horn-dust  lying  in  its  teeth  may 
be  examined.  If  this  is  getting  slightly  bloodstained,  we 
know,  of  course,  that  the  sensitive  structures  are  reached, 
and  the  incision  has  been  carried  far  enough.  In  so  judging 
the  depth  of  the  incision,  however,  care  must  be  taken  to 
see  that  the  top  of  the  coronary  cushion  is  not  injured  with 
Lhe  saw,  for  if  this  is  done  the  blood  trickling  into  the  depth 
of  the  incision  will  tinge  the  horn-dust,  and  give  the  false 
impression  that  the  incision  is  sufficiently  deep. 

If  the  operator  has  had  no  previous  experience  of  the 
use  of  the  saw  in  this  operation,  he  must  also  be  careful  to 

*  That  is  Smith's  older  pattern.  The  newer  pattern  (Fig.  145) 
has  the  teeth  so  set  as  to  make  an  incision  wide  enough  to  be  looked 
into.  In  this  case  the  depth  arrived  at  is  to  be  judged  by  the 
appearance  of  the  bottom  of  the  incision. 


374        DISEASES  OF  THE  HORSE'S  FOOT 

avoid  placing  too  great  a  pressure  on  the  teeth  of  its  lower 
third.  This  is  done  by  keeping  the  hand  too  greatly  de- 
pressed. Again,  this  leads  to  wounding  of  the  sensitive 
structures  (this  time  at  the  lower  end  of  the  incision),  and 
again  the  operator  is  confused  by  the  blood  thus  allowed  to 
run  into  the  groove. 

The  only  portion  of  horn  difficult  to  operate  on  is  that 
immediately  under  the  coronet.  This  is  best  severed  with 
a  succession  of  downward  movements,  and  is  easier  per- 
formed with  Smith's  later  pattern  of  side-bone  saw  (Fig. 
145)  in  which  the  set  of  the  foremost  teeth  is  reversed. 

Im  making  these  grooves  we  must  say  that  we  think  the 
use   of   the   special   saw   may  be   dispensed   with,   and   the 


Fig.    145. — Smith's   Side-bone   Saw    (Improved   Pattern). 

incisions  just  as  easily,  or,  at  any  rate,  just  as  successfully, 
made  with  the  knife.  Those  who  select  to  use  this  instru- 
ment should  choose  a  narrow-topped  and  sharp  searcher,  or 
a  modern  shaped  drawing-knife  of  suitable  size,  such  as 
ihose  depicted  in  Fig  46,  a  and  b,  and  they  will  find  their 
work  much  easier  if  they  will  make  the  first  steps  in  the 
incisions  with  an  ordinary  flat  firing-iron.  By  the  use  of 
the  latter  instrument  the  grooves  are  made  conveniently 
open  along  their  tops,  and  room  left  for  nicely  finishing  the 
more  delicate  manner  of  removing  with  the  knife  the  softer 
horn  near  the  sensitive  structures. 

Those  whose  leaning  is  towards  the  use  of  special  instru- 
ments, but  who,  at  the  same  time,  do  not  care  to  use  the 
saw,    will    find    their    wants    supplied    in    the    hoof    plane 


DISEASES  OE  THE  LATERAL  CARTILAGES  375 

(  Smith's  ).  Fig.  146,  or  the  hoof  chisel  (  Hodder's  ),  Fig.  147. 
With  the  hoot  plane  the  groove  in  the  wall  is  made  by  a 
succession  of  downward  scraping  movements,  while  with 
the  chisel  the  cut  in  the  wall  is  made  either  from  below 
upwards,  or  from  above  downwards,  according  as  the  foot 
is  held  forward  or  backward — whichever,  in  fact,  comes 
most  convenient. 

When  using  the  knife  or  the  hoof  plane  it  is  not  often 


Fig.    145.— Hoof    Plane    (Smith's). 

that  the  sensitive  structures  are  injured.  In  all  cases, 
however,  no  matter  what  the  instrument  used,  the  metal 
gauge  should  be  employed  when  the  sensitive  structures 
have  been  touched,  and  the  operation  obscured  by  blood. 

Our  instruments  at  hand,  the  operation  may  be  proceeded 
with.  The  first  step  is  to  ascertain  the  extent  of  the  side- 
bone,  and  to  determine  the  position  of  the  incisions.  To  do 
this  the  coronet  is  felt  with  the  thumb,  and  the  anterior 


Fig.  147.— Hoof  Chisel  (Hodder's). 


extremity  of  the  side-bone  noted.  This  is  marked  on  the 
horn  with  a  piece  of  chalk,  and  a  vertical  line  dropped  from 
this  position  to  the  inferior  margin  of  the  wall  (  Fig.  148,  1  ). 
The  line  crosses  the  horn  fibres  obliquely,  and  is  purposely 
made  in  that  direction  in  order  that  its  inferior  end  may  be 
far  enough  back  to  avoid  the  last  nail-hole.  Should  the 
side-bone  reach  very  far  forwards,  it  may  be  wise  to  cause 
this  line  to  slant  from  before  backwards  (see  dotted  line  a, 
Fig.  148).    Unless  this  is  done,  it  is  found  that  in  some 


376         DISEASES  OF  THE  HORSE'S  FOOT 

feet  so  much   of  the  wall   is   isolated   at  the   bottom   that 
insufficient  is  left  to  nail  the  shoe  to. 

The  next  line  to  be  made  is  the  rear  one.  Its  correct 
position  is  ascertained  by  first  noting  the  junction  off  the 
wall  with  the  bar  (see  groove  2,  Fig.  149)  ;  and  its  inferior 
end  must  be  just  anterior  to  the  inflexion  of  the  wall.  This 
is  done  that  we  may  avoid  cutting  the  bar.  The  position 
oi  the  lower  end  of  the  rear  line  thus  ascertained,  it  is  run 
upwards  with  the  chalk  in  the  direction  of  the  horn  fibres. 


13     2 

Fig.   148. — Diagram  illustrating  the  position  of  the  Grooves  in 
the  Wall  in  Colonel  Smith's  Operation  for  Side-bone. 

i,  2,  and  3,  mark  the  grooves  in  the  order  in  which  they  are  made; 

the  dotted  line  a  marks  the  position  taken  by  the  anterior  line 

Vher.the  side-bone  is  one  reaching  far  forward, while  the  dotted 

lines  fr  and  c  mark  the  position  of  the  additional  grooves  to  be 

made  if  thought  necessarv. 


The  third  line  is  made  in  such  a  position  as  to  divide 
into  two  equal  portions  the  wall  between  lines  1  and  2. 
Here,  however,  some  operators  prefer  to  make  two,  or  even 
three,  lines,  adding  those  as  at  b  and  c,  Fig.  148;  and 
Smith  himself  says  that  a  multiplicity  of  lines  is  an  advant- 
age rather  than  not. 

In  any  case,  having  once  determined  the  position  of  the 
lines,  they  should  be  plainly  marked  out  with  chalk,  and 
then  viewed  from  a  distance  with  the  foot  on  the  ground,  in 


DISEASES  OF  THE  LATERAL  CARTILAGES    377 

order  to  judge  of  their  regularity.  If  we  are  satisfied  with 
them,  we  then  lightly  mark  them  with  the  saw.  with  the 
hot  iron,  or  with  the  knife,  whichever  instrument  we  may 
be  intending  to  use. 

Unless  the  details  are  methodically  carried  out  as  here 
described,  it  is  probable  that  more  of  the  foot  will  be  isolated 
than  is  necessary,  and  that  as  a  consequence  very  little 
is  left  to  which  to  nail  the  shoe. 


Fig.  149. — Diagram  illustrating  the  Position  of  the  Grooves 
made  in  the  Hoof  in  Colonel  Smith's  Operation  for  Side- 
bones. 

i,  2,  and  3,  show  the  grooves  in  the  wall  in  the  order  in  which  they 
are  made ;  4  shows  the  groove  made  at  the  junction  of  the  sole 

with   the  wall. 


The  incisions  are  then  made  with  the  saw  or  the  knife, 
with  the  foot  held  in  a  convenient  position  by  an  assistant. 
That  usually  found  most  comfortable  for  the  first  incision  is 
with  the  foot  held  forwards  and  placed  on  an  assistant's 
thigh  in  the  position  adopted  for  '  clenching  up '  when 
shoeing,  while  that  for  the  rear  incision  is  with  the  animal's 
knee  flexed,  and  the  foot  held  well  up  to  the  elbow.  In 
this,  however,  each  operator  will  suit  himself. 

Should  the  preliminary  steps  in  making  the  incisions  be 
performed  with  the  iron,  it  will  be  easiest  done  with  the 
foot  on  the  ground. 


378        DISEASES  OF  THE  HORSE'S  FOOT 

When  the  incisions  through  the  wall  are  complete,  our 
attention  must  be  given  to  the  sole.  A  drawing-knife  is 
here  used,  and  a  further  incision  made  over  the  white  line 
so  as  to  destroy  the  union  of  the  sole  with  the  wall  between 
incisions  1  and  2,  and  so  completely  isolate  the  portions 
cf  wall  included  within  the  four  grooves  (see  groove  4, 
Fig.  149).  When  this  is  done  it  should  be  found  that  the 
portions  of  the  isolated  wall  spring  readily  to  pressure  of 
the  thumb. 

The  inferior  or  wearing  margin  of  the  isolated  wall  must 
now  be  so  trimmed  that  it  takes  no  bearing  on  the  ground 
when  the  opposite  limb  is  held  up  by  an  assistant  and  full 
weight  placed  upon  the  foot. 

For  a  day  or  two  after  the  operation  lameness  is  intense. 
This  is  to  be  treated  with  hot  poultices  or  hot  baths,  and 
soon  disappears.  Three  to  four  days  later  a  bar  shoe 
is  nailed  on  (taking  care  that  the  bearing  of  the  quarters  is 
still  eased),  and  the  hot  poultices  still  continued.  Four 
days  later  still  walking  exercise  may  be  commenced,  to  be 
followed  shortly  afterwards  by  trotting.  At  about  the 
twelfth  day  some  animals  may  conveniently  be  put  to  work, 
while  in  other  cases  a  fortnight,  or  even  a  month,  must 
elapse  before  this  can  be  done.  When  put  to  work  early,  it 
is  wise  to  fill  in  the  fissures  made  in  the  wall  with  hard 
soap,  with  wax,  or  with  a  suitable  hoof  dressing,  in  order 
that  irritation  of  the  sensitive  structures  with  outside  matter 
may  be  prevented. 

This  operation  is  soon  followed  by  remarkable  changes  in 
the  shape  of  the  foot.  At  about  the  third  week  the  coronet 
shows  signs  of  bulging,  and  the  upper  part  of  the  wall 
operated  on  is  often  so  protruding  as  to  render  the  foot 
wider  here  than  at  the  ground  surfaces.  This  is  a  sign  that 
the  case  is  doing  well. 

Should  no  improvement  be  noticed  at  the  end  of  three 
weeks  or  a  month,  or  should  the  grooves  become  filled  from 
the  bottom  (which  they  do  remarkably  fast),  then  the 
incisions  must  be  deepened,  the  exercise  reduced,  and  the 
fomentations    or    poulticing    repeated,      So    treated,    many 


DISEASES  OF  THE  LATERAL  CARTILAGES    379 

cases  of  side-bone  lameness  will  be  relieved,  if  not  entirely 
cured,  and.  should  the  worst  happen,  and  no  alteration 
in  the  lameness  is  noticeable,  no  harm  will  have  been  done 
to  the  foot.  In  this  connection,  the  originator  of  the  treat- 
ment says :  '  I  may  assure  those  induced  to  doubt  either 
their  diagnosis  or  the  value  of  hoof  section  that  no  harm 
is  done  to  the  foot,  even  should  the  operation  be  of  no 
value.  It  may  do  much  good ;  it  cannot  do  harm.  The 
operation  will  never  succeed  until  the  inherent  timidity 
of  sawing  or  cutting  into  the  wall  is  overcome.  The  incisions 
must  be  deep,  and  of  the  same  depth  from  the  coronet  to  the, 
ground:* 

It  is  well  to  remark  here  that  the  operation  of  hoof  section 
cannot  be  expected  to  succeed  in  every  case.  The  last  man 
in  the  world  to  claim  that  for  it  would  be  its  originator. 
Failure  to  relieve  the  lameness  may  be  accounted  for  in 
a  variety  of  ways.  First,  of  course,  will  come  errors  in 
diagnosis.  Xo  one  of  us  is  infallible,  and  the  lameness  we 
have  judged  as  resulting  from  side-bone  may  arise  from 
another  cause.  There  are,  too,  complications  to  be  reckoned 
with,  the  existence  or  absence  of  which  cannot  always  be 
definitely  ascertained.  Such  are :  Ringbone,  especially  that 
form  of  ringbone  known  as  ;  low  ' ;  bony  deposits  on  the 
pedal  bone,  either  on  its  laminal  or  plantar  surface,  or  even 
changes  in  the  navicular  bursa. 

*  Journal  of  Comparative  Pathology  and  Therapeutics,  vol.  iii., 
p.   3i3. 


CHAPTER  XI 
DISEASES  OF  THE  BONES 

A.    PERIOSTITIS  AND  OSTITIS. 

We  head  this  section,  Periostitis  and  Ostitis,  for  the  reason 
that  in  actual  practice  it  is  rare  for  one  of  these  affections 
to  occur  without  the  other.  The  periosteum  and  the  bone 
are  so  intimately  connected  that  it  is  difficult  to  conceive  of 
disease  of  the  one  failing  to  communicate  itself  in  some 
degree  to  the  other.  Pathologically,  however,  and  for 
purposes  of  description,  it  is  more  convenient  to  describe 
separately  the  abnormal  changes  occurring  in  these  two 
tissues. 

With  the  main  phenomena  of  inflammation  occurring 
elsewhere  we  presume  our  readers  are  aware.  Briefly  we 
may  put  it,  that  under  the  action  of  an  irritant,  either 
actual  injury,  chemical  action,  or  septic  infection,  the  healthy 
tissues  around  react  in  order  to  effect  repair  of  the  parts 
destroyed.  Also  that  this  reaction  involves  the  distribution 
of  a  greater  blood-supply  to  the  part,  with  an  abundant 
migration  of  leucocytes,  and  the  outpouring  of  an  inflam- 
matory exudate,  together  with  symptoms  of  heat,  pain,  red- 
ness, and  swelling  of  the  affected  area.  And  that  in  chronic 
inflammations,  owing  to  persistence  of  the  cause,  the  process 
of  repair  thus  instituted  does  not  stop  at  mere  restoration  of 
lost  tissue,  but  continues  to  the  extent  of  forming  an  abnor- 
mal quantity  of  such  tissue  as  normally  exists  in  the  parts 
implicated. 

The  process  of  inflammation  in  bone  is  essentially  the 

380 


DISEASES  OF  THE  BOXES  381 

same.  It  takes  place  along  the  course  of  the  bloodvessels, 
and  is  only  modified  in  its  attendant  phenomena  by  the 
structure  of  the  parts  involved.  Swelling,  for  instance, 
cannot  take  place  in  the  centre  of  compact  bone  tissue. 
Otherwise,  other  changes  occur  exactly  as  in  inflammations 
of  other  structures. 

When  the  causal  irritant  has  been  excessively  severe  and 
the  migration  of  leucocytes  abundant,  actual  formation  of 
pus  may  occur,  the  bony  tissue  being  broken  down  and 
mingled  with  it,  and  an  abscess  cavity  formed.  In  milder 
cases,  affected  and  necrotic  tissue  is  removed  by  a  process  of 
phagocytosis,  and  new  tissue  (this  time  osseous)  formed  in 
its  place. 

In  the  periosteum  we  may  take  it  roughly  that  inflamma- 
tion runs  a  course  similar  to  that  occurring  in  soft  tissues 
elsewhere.  There  is  but  one  exception,  and  that,  as  we  shall 
mention  shortly,  is  connected  with  its  deeper  layer. 

As  we  know,  the  periosteum  consists  of  two  layers,  an 
cuter  fibrous  and  an  inner  yellow  elastic,  and  is  extremely 
vascular.  Numerous  bloodvessels  ramify  in  it,  and,  with 
their  attendant  nerves,  break  up  to  enter  the  numberless 
canals  of  the  Haversian  system.  This  extreme  vascularity, 
of  course,  favours  abundant  exudation.  This  exudate,  how- 
ever, is,  as  it  were,  shut  in  by  the  dense  fibrous  layer  of  the 
membrane,  and  the  result  is  that  in  periostitis  it  collects 
between  the  membrane  and  the  bone,  causing  swelling  and 
raising  of  the  membrane,  and  giving  rise  to  excruciating 
pain  from  pressure  upon  the  nerves. 

Should  the  periostitis  be  complicated  by  the  formation  of 
pus,  then  the  vessels  entering  and  supplying  the  bone  are, 
in  the  suppurative  area,  destroyed.  With  their  destruction 
it  may  happen  that  we  get  also  death  of  a  portion  of  the 
osseous  tissue.  This,  however,  when  the  suppuration  is 
abundant,  cannot  commonly  occur,  as  the  bloodvessels 
within  the  bone — those  of  the  medulla — commence  to  supply 
blood  to  the  affected  part.  In  cases  of  trouble  with  the 
bones  of  the  foot,  these  last  few  remarks  have  a  special 
significance.     Here  we  have  three  bones  whose  medullary 


382        DISEASES  OF  THE  HORSE'S  FOOT 

cavity  is  extremely  small — almost  nil,  in  fact — which  *•*.'. 
plains  in  some  measure  how  easy  it  is  when  suppuration 
exists  to  get  necrosis  and  exfoliation  of,  say,  portions  of  the 
os  pedis.  Necrosis  and  sloughing  of  the  periosteum  itself 
may  also  happen,  but  as  the  extreme  vascularity  of  the  mem- 
brane is  a  fairly  strong  safeguard  against  that  it  is  of  only 
rare  occurrence. 

In  connection  with  the  deep  layer  of  the  periosteum,  and 
forming  part  of  it,  are  found  numerous  bone-forming  cells 
(osteoblasts) .  These,  under  ordinary  conditions,  are  rela- 
tively quiescent.  Under  the  slightest  irritation  or  stimula- 
tion, however,  their  bone-forming  functions  are  stirred  into 
abnormal  activity,  thus  explaining  how  easy  it  is  (especially 
with  bones  so  open  to  receive  slight  injuries  as  are  those  of 
the  foot)  to  get  ossific  deposits,  the  starting-point  of  which 
we  are  quite  unable  to  account  for. 

With  this  brief  introduction  we  will  now  describe  such 
pathological  changes  as  occur  in  the  separate  structures, 
and  which  we  are  likely  to  encounter  in  the  various  diseases 
of  the  foot.  While  so  doing,  we  shall  draw  attention  to  such 
diseases  as  we  have  previously  described  in  which  the 
pathological  conditions  we  are  considering  may  be  met  with. 

1.  Periostitis. 

This  we  shall  consider  under  (a)  Simple  Acute  Periostitis, 
(b)  Suppurative  Periostitis,  (c) Osteoplastic  Periostitis). 

(a)  Simple  Acute  Periostitis. — This  is  the  periostitis  that 
follows  on  the  infliction  of  a  slight  injury  to  the  membrane 
— an  injury  without  an  actual  wound  and  free  from  infective 
material.  It  is  one,  therefore,  which  we  always  judge  as 
existing  in  those  cases  where  we  have  distinct  evidence  or 
history  of  injury,  but  in  which  the  injury  has  not  been 
severe  enough  to  lead  to  fracture  or  to  the  infliction  of  an 
actual  wound. 

Such  cases  may  be  those  of  lameness  persisting  after 
violent  blows  upon  the  foot — cases  where  the  animal  has 
been  kicking  against  the  stable  fittings,  or  where  the  foot 


DISEASES  OF  THE  BOXES  383 

has  been  partially  passed  over  by  the  wheel  of  a  waggon. 
It  may  be,  too,  that  in  a  case  of  '  nail-bound  '  a  great  deal 
of  the  pain  and  lameness  is  due  to  a  simple  periostitis 
caused  by  pressure  of  the  bulged  inner-layer  of  horn  upon 
the  sensitive  structures. 

Simple  acute  periostitis  may  also  occur  in  cases  where 
an  actual  wound  is  in  existence,  but  where  such  wound, 
fortunately,  remains  aseptic.  We  may  thus  have  this  con- 
dition accompanying  ordinary  cases  of  pricked  foot,  of 
treads  in  the  anterior  region  of  the  coronet,  and  of  acci- 
dental injuries  of  other  kinds. 

In  simple  acute  periostitis  the  membrane  is  thicker  and 
redder  than  normal,  and  is  easily  stripped  from  the  bone. 
As  it  is  pulled  off  it  is  noticed  that  there  are  numerous 
fibril-like  processes  hanging  to  its  inner  surface,  and  which 
draw  out  from  the  substance  of  the  bone.  These  are  simply 
the  vessels  (bloodvessels  and  nerves)  which,  loosened  by  the 
inflammatory  exudate,  are  readily  detached  and  drawn  from 
the  Haversian  canals  into  which  they  normally  run.  In 
addition  to  its  increased  redness,  the  membrane  has  a  swollen 
and  gelatinous  appearance  owing  to  its  infiltration  with  the 
inflammatory  discharges.  Simple  acute  periostitis  may  and 
often  does  end  in  resolution.  On  the  other  hand,  it  may 
end  in  suppuration  or  may  become  chronic.  If  the  latter, 
then  the  osteoblasts  of  the  innermost  layer  become  active, 
and  abnormal  deposits  of  bone  are  the  result. 

(b)  Suppurative  Periostitis. — This  condition  simply  in- 
dicates that  the  inflammation  is  complicated  by  the  presence 
of  pus  organisms.  It  is,  therefore,  a  common  termination 
of  the  simple  acute  form  attending  the  infliction  of  a  wound. 
The  wound  becomes  contaminated,  and  in  case  of  simple 
periostitis  is  soon  changed  into  the  suppurative  form.  Once 
having  gained  entrance  to  the  wound,  the  pus  increases  in 
quantity,  and  slowly  runs  between  the  membrane  and  the 
bone.  This,  however,  it  does  not  do  to  any  large  extent, 
showing  rather  a  tendency  to  penetrate  the  outer  fibrous 
layer  and  gain  the  outside  of  the  membrane. 

Suppurative  periostitis  is  met  with  in  foot  cases,  com- 


384        DISEASES  OF  THE  HORSE'S  FOOT 

monly  in  connection  with  punctured  foot.  It  occurs,  too,  as 
a  complication  in  suppurating  corn,  in  severe  tread,  in  com- 
plicated sand-crack,  as  a  result  of  the  spread  of  suppurative 
matter  in  acute  coronitis,  and  in  sub-horny  quittor. 

In  ordinary  cases  of  suppurative  periostitis  the  pus  formed 
is  yellow  in  colour,  creamy  thick,  and  free  from  pronounced 
odour — the  so-called  k  laudable  '  pus  of  the  older  writers. 
It  so  happens  in  many  cases  of  foot  trouble,  however,  that 
putrefactive  organisms  gain  entrance  side  by  side  with  those 
of  pus.  In  this  case  the  characters  of  the  discharge  are 
very  different.  It  is  distinctly  more  fluid,  is  of  a  pink  or 
even  light  chocolate  colour,  and  extremely  offensive.  In 
these  instances  the  pus  shows  a  marked  tendency  to  spread, 
strips  the  periosteum  from  the  bone,  perforates  the  outer 
layer  of  the  membrane,  and  finally  infiltrates  the  surround- 
ing tissues. 

This  forms  a  near  approach  to  what  is  known  in  human 
surgery  as  an  infective  periostitis,  and  in  our  subjects  is 
nearly  always  met  with  in  cases  of  severe  prick.  Its  rapidly 
spreading  character  makes  it  always  a  dangerous  condition, 
and  a  punctured  foot  exuding  a  discharge  of  this  nature 
should  always  be  regarded  as  serious.  The  close  contiguity 
of  the  joint  (it  can  never  be  far  distant  in  foot  cases),  the 
spreading  character  of  the  disease,  and  the  rapidity  with 
which  the  horse  succumbs  to  arthritis,  are  all  factors  to  be 
taken  into  consideration,  and  to  lead  to  a  warning-note  being 
struck  when  attending  a  case  of  such  kind. 

A  further  instance  of  infective  periostitis  is  that  met  with 
in  acute  laminitis.  The  discharge  obtained  from  the  sole  in 
these  cases  very  often  bears  the  character  we  have  just 
described,  and  when  one  considers  the  thinness  of  the 
keratogenous  membrane,  one  is  bound  to  admit  that  changes 
so  grave  occurring  in  it  cannot  fail  to  spread  and  infect  the 
periosteum. 

( c)  Osteoplastic  Periostitis. — This  is  more  particularly  a 
chronic  process,  and  is,  •  as  the  suffix  '  plastic  '  indicates, 
associated  with  bone-forming  changes  in  the  membrane. 
It   may  occur   as   a   consequence   of   slight   but   continued 


DISEASES  OF  THE  BONES  385 

irritation,  often  without  ascertainable  origin    (see  Case  2, 
p.  392),  or  it  may  be  the  sequel  of  acute  disease. 

In  this  form  of  periostitis  the  membrane  is  again  swollen 
and  more  vascular  than  in  health,  and  is  also  easily  separ- 
able from  the  bone.  The  exposed  bone  is  generally  rough. 
in  some  cases  even  spicular,  and  the  inner  layer  of  the 
removed  membrane  is  rough  and  gritty  to  the  touch — 
characters  imparted  to  it  by  numerous  minute  fragments 
of  bone  that  have  been  torn  away  with  it  from  the  more 
compact  osseous  tissue  beneath. 

The  results  of  an  osteoplastic  periostitis  are  frequently 
met  with  in  the  bones  of  the  foot,  and  are  described  by 
veterinary  writers  under  such  headings  as  '  Pedal  Exostoses,' 
'Ossifying  Ostitis,'  and  'Pedal  Ossification'  (see  Figs. 
152,  153,  154,  and  155).  In  many  of  these  cases  the 
disease  is  purely  chronic,  and  the  original  cause  nearly 
always  wanting.  When  the  foot  has  been  subjected  to 
laminitis  of  some  weeks'  duration,  the  same  condition  is 
also  met  with,  being  at  the  same  time  associated  with  rare- 
factive  osteoplastic  ostitis,  conditions  which  we  shall  shortly 
describe.  Cases  we  have  examined  have  undoubtedly  shown 
this  conditions  of  osteoplastic  periostitis,  the  rarefactive  and 
osteoplastic  changes  in  the  bone  itself,  met  with  in  older 
cases,  occurring  no  doubt  as  a  result  of  non-expansion  of 
the  horny  box.  So  far  as  we  are  able  to  ascertain,  there  is 
every  reason  to  believe  that  in  chronic  laminitis  the  accom- 
panying periostitis  leads  to  the  formation  of  bone,  and 
would,  if  it  were  possible,  lead  to  increase  in  the  size  of  the 
os  pedis.  If  proof  were  wanted  of  this,  it  is  only  necessary 
to  point  out  the  increased  growth  at  points  where  resistance 
is  nil — namely,  along  the  upper  margin  of  the  bone  (see 
Fig.  118).  Hqwever,  increase  in  size  elsewhere,  is  pre- 
vented by  the  resistance  of  the  hoof,  so  that,  as  the  bone- 
forming  process  progresses,  as  it  inevitably  must  under  the 
inflammatory  changes  going  on,  it  is,  as  it  were,  compen- 
sated for  by  rarefaction  or  bone-absorption  changes  occur- 
ring simultaneously  with  it. 


386         DISEASES  OF  THE  HORSE'S  FOOT 

2.  Ostitis. 

We  shall  next  deal  with  the  inflammatory  changes  occur- 
ring in  the  bones  themselves,  and  shall  consider  them 
under  (a)  Rarefying  or  Raref active  Ostitis,  \(b)  Osteoplastic 
Ostitis,  and  (c)  Caries  and  Necrosis. 

Inflammatory  changes  occurring  in  the  medulla  we  may 
pass  without  consideration,  for  in  the  bones  of  the  foot  the 
medullary  cavity  is  so  small,  and  the  changes  taking  place 
in  it  of  such,  minor  importance,  that  we  may  do  this  with- 
out in  any  way  seriously  prejudicing  our  work. 

(a)  Rarefying  or  Raref  active  Ostitis. — By  this  term  is 
indicated  an  inflammation  of  the  bone  attended  by  its 
absorption,  the  absorption  being  due  to  the  action  of 
certain  cells,  termed  osteoclasts.  This  condition  may  be 
due  to  the  pressure  of  tumours,  may  occur  as  the  result  of 
injury  when  a  piece  of  bone  is  stripped  of  periosteum,  or 
may  be  the  result  of  an  inflammation  occurring  in  the 
periosteum  elsewhere. 

A  piece  of  bone  undergoing  rarefactive  ostitis  is  redder 
than  normal,  and  the  openings  of  the  Haversian  canals 
are  distinctly  increased  in  size.  As  a  result  a  greater 
number  of  them  become  visible.  Their  increase  in  size 
is  due  to  the  inflammatory  absorption  of  the  bony  tissue 
forming  them,  and  in  the  larger  of  them  may  be  seen 
inflammatory  granulation  tissue  surrounding  the  blood- 
vessels. This  enlargement  of  the  Haversian  canals  is  well 
seen  when  the  bone  is  macerated,  the  whole  then  giving 
the  appearance  of  a  piece  of  very  rough  pumice-stone. 

This  process  of  rarefaction  or  absorption  of  bone  tissue 
may  be  confined  to  quite  a  small  portion,  or  it  may  be 
spread  over  the  whole  of  the  bone,  rendering  it  more 
porous  than  is  normal,  but  stopping  short  of  complete 
destruction  of  the  bone  tissue  (a  condition  which  is  some- 
times known  as  inflammatory  osteoporosis  (see  Fig.  118). 
In  this  latter  case  the  condition  is  a  chronic  one,  and  the 
bone  tissue  remaining  often  appears  to  be  strengthened  by 
a  compensatory  process  of  condensation. 


DISEASES  OF  THE  BONES  387 

For  an  example  of  rarefactive  ostitis  as  met  with  in  cases 
of  disease  of  the  feet,  we  refer  the  reader  to  laminitis  (see 
Fig.  118).  The  osteoplastic  or  condensing  process  that 
appears  to  exist  simultaneously  with  it  explains,  no  doubt, 
how  it  is  that  bones  so  affected  do  not  more  commonly 
fracture. 

A  further  example  of  this  process  is  illustrated  in 
Fig.  133.  The  pressure  of  a  tumour  (in  this  case  a  kera- 
phyllocele)  has  led  to  rarefactive  changes  in  the  bone, 
forming  a  neat  indentation  in  the  normal  contour  of  the 
bone  which  serves  to  accommodate  the  tumour. 

(b)  Osteoplastic  Ostitis,  Osteosclerosis,  or  Condensation 
of  Bone. — This,  too,  is  essentially  a  chronic  process.  It  may 
occur  as  a  result  of,  or,  as  we  have  just  shown,  exist  simul- 
taneously with  the  condition  of,  diffuse  rarefactive  ostitis. 
In  this  case  there  is  a  formation  of  new  bone  in  the  con- 
nective tissue  surrounding  the  vessels  in  the  Haversian 
canals.  As  a  consequence  the  bone  affected  is  greatly 
increased  in  density,  and  many  of  the  Haversian  canals 
by  this  means  obliterated.  The  end  result  is  an  increase 
in  size  of  the  bones  in  such  positions  as  the  horny  box 
admits  of  it,  and  a  peculiar  ivory-like  change  in  their 
consistence. 

For  an  example  of  this,  we  again  refer  the  reader  to  the 
changes  occurring  in  chronic  laminitis. 

(c)  Caries  and  Necrosis. — Caries  is  a  word  which  ap- 
pears to  be  used  with  a  considerable  amount  of  looseness. 
In  addition  to  the  meaning  implied  by  necrosis  (namely, 
'death'  of  the  part),  caries  is  generally  used  to  indicate 
that  there  is  also  a  condition  of  rottenness,  decay,  and 
stench.  It  is  particularly  applied,  in  fact,  when  the  death 
of  the  bone  is  slowly  progressive,  and  is  due  to  the  inroads 
made  upon  it  by  putrefactive  or  septic  matter. 

Necrosis  of  bone  may  be  the  result  of  an  injury,  such  as 
severe  blows,  or  pricks  and  stabs.  In  such  cases  it  would 
appear  that  it  is  loss  of  a  portion  of  periosteum  that  is  the 
starting-point.  With  death  of  a  portion  of  this  membrane 
the  vascular  supply  to  a  portion  of  the  bone  is  cut  off,  and 


3SS        DISEASES  OF  THE  HORSE'S  FOOT 

necrosis  ensues.  It  may  also  result  from  the  extension  of 
inflammatory  affections  of  the  structures  adjoining  it,  as, 
for  instance,  the  spread  of  the  infective  material  in  severe 
tread,  or  the  encroaches  made  by  pus  in  cases  of  quittor, 
suppurating  corn,  or  complicated  sand-crack. 

When  the  necrosed  portion  of  bone  is  small,  and  is 
free  from  infective  properties,  it  is  quite  possible  that  it 
may,  as  is  the  case  with  small  spots  of  necrosis  in  softer 
tissues,  be  removed  by  a  process  of  absorption.  It  must 
be  remembered,  however,  that  where  the  necrosis  has 
occurred  as  a  result  of  septic  invasion  this  cannot  be  looked 
for,  for  in  every  case  such  reparative  changes  are  worked 
solely  by  healthy  tissue.  If  the  tissues  around  the  necrosis 
are  engaged  in  dealing  with  organismal  invasion  and  the 
poisonous  products  thus  poured  into  their  working  area, 
their  state  of  health  is  so  weakened  that  they  are  unable  to 
successfully  combat  with  the  two  conditions  simultan- 
eously. As  a  consequence,  the  necrotic  piece  of  bone 
persists,  and  acts  as  a  permanent  source  of  irritation. 

It  must  be  remembered,  too,  that  if  the  dead  portion  of 
bone — even  though  it  be  free  from  septic  matter — is  very 
large,  that  it  may  itself  act  as  a  continual  irritant,  in  which 
case  it  again  persists,  and  cannot  by  natural  means  be 
removed. 

In  our  cases  necrosis  of  bone  may  be  met  with  in  punc* 
tured  foot,  in  severe  cases  of  tread,  in  cases  of  complicated 
crack,  and  in  suppurating  corn.  It  is  met  with,  too,  in 
navicular  disease,  in  the  extension  of  irritating  discharges 
in  cases  of  quittor,  and  in  cases  of  chronic  laminitis  where 
the  solar  margin  of  the  os  pedis  has  penetrated  the  sole. 
In  this  latter  case  the  protruding  portion  of  bone  is  quickly 
denuded  of  its  periosteum.  Its  blood-supply  is  destroyed, 
and  necrosis  follows. 

Treatment. — In  simple  cases  of  periostitis,  those  caused 
by  a  blow  but  free  from  an  actual  wound,  the  most  bene- 
ficial treatment  is  the  continued  application  of  cold  by 
means  of  a  hose-pipe  or  by  swabs.  If  by  these  means  we 
are  successful  in  holding  the  inflammatory  phenomena  in 


DISEASES  OF  THE  BOXES  389 

check,  any  large  formation  of  new  bone  is  prevented,  and 
the  case  does  well. 

When  the  case  is  complicated  by  a  wound,  then  anti- 
septic measures,  such  as  those  described  in  the  treat- 
ment of  punctured  foot,  will  at  the  same  time  have  to  be 
practised. 

It  must  be  admitted,  however,  that  in  all  but  the  most 
simple  cases  ordinary  treatment  such  as  this  is  of  very 
little  use ;  for  with  only  a  slight  exostosis  in  almost  any 
position  in  the  foot,  excessive  lameness  presents  itself  and 
remains.  In  such  cases  nothing  is  left  to  us  but  the 
operation  of  neurectomy. 

When  tTie  periostitis  and  ostitis  is  the  result  of  a  wound, 
and  is  complicated  by  caries  or  necrosis  of  the  bone,  the 
diseased  portion  of  bone  must  in  every  case  be  laid  bare 
and  removed.  It  so  happens  that  the  majority  of  cases  of 
this  kind  occur  in  positions  where  the  diseased  bone  is 
easily  got  at.  The  lower  margin  of  the  os  pedis  or  portions 
of  the  wings  are  commonly  the  seat  of  such  changes.  We 
meet  with  the  former  in  cases  of  pricked  foot,  and  with  the 
latter  in  severe  cases  of  tread,  or  as  a  complication  in  sup- 
purating corn  or  in  quittor.  In  such  cases  the  animal  must 
be  cast  and  the  foot  secured.  The  wound  is  then  followed 
up,  the  horn  if  necessary  removed,  and  the  bone  curetted 
with  a  Volkmann's  spoon;  or,  if  showing  itself  as  a  seques- 
trum, removed  with  a  scalpel  and  a  strong  pair  of  forceps. 
Care  must  be  taken  that  every  particle  of  the  diseased  bone 
is  removed,  and  that  no  part  of  it  is  left  to  act  as  an  after- 
source  of  irritation.  With  removal  of  the  diseased  portion 
and  a  strict  attention  to  antisepsis  healing  soon  takes 
place. 

Reported  Cases  of  Periostitis  and  Ostitis. — 1.  'Figs.  150 
?.nd  151  represent  the  phalangeal  bones  of  the  off  fore-leg 
of  a  thoroughbred  horse  named  Osman,  who  was  well 
known  as  a  hunt  steeplechaser  of  considerable  merit  in  the 
Midland  counties  some  twenty  years  ago.  I  may  say  that 
this  horse  was  under  my  observation  pretty  regularly  during 
the  whole  of  his  career,  and  up  to  the  time  of  his  death. 


390        DISEASES  OF  THE  HORSE'S  FOOT 

from  ruptured  aorta,  when  eight  years  old.  My  attention 
was  called  to  him  as  a  yearling  by  his  owner,  who  told  me 
that  he  sometimes  fancied  the  colt  was  lame.  I  went  over 
to  see  him,  and  found  that  he  was  unmistakably  lame  on 
the  off  fore-leg.  Careful  examination  showed  no  heat  or 
enlargement  anywhere.  I  advised  rest  and  the  colt  became 
pretty  sound,  though  not  quite  so — in  fact,  he  never  did 


Fig.  150.— Effects   of 


Periostitis  on 
Bones. 


the  Pedal  and  Navicular 


become    quite    sound,    and    sometimes    he    was    very    lame 
indeed. 

*  Every  imaginable  sort  of  treatment  was  tried  short  of 
neurectomy,  without  avail.  The  curious  part  of  the  case 
was  that  there  never  was  much  heat  or  any  apparent 
change  of  structure,  nor  was  "  pointing  "  a  very  noticeable 
feature.  The  foot  always  remained  a  good-looking  one. 
As  the  horse  won  a  good  number  of  races  he  was  of  some 
value,  and  was  seen  by  a  good  many  members  of  the  pro- 


DISEASES  OF  THE  BONES 


391 


fession,  who  were  by  no  means  unanimous  as  to  the  cause 
of  lameness.  The  favourite  theory  was  that  it  was  a 
sequence  of  "  split  pastern."'  A  post-mortem  examination 
showed  that  there  was  no  fracture.  There  was  no  adher- 
ence of  the  tendon  to  the  navicular  bone  nor  any  ulcera- 
tion. The  morbid  changes  consisted  entirely  of  osseous 
deposit  as  shown  in  the  photographs.  The  under  surface 
of  the  navicular  bone  was  much  enlarged  and  roughened 


tm    ^^^ 

.\7  Jf 

-  ■  ay  \ 

iSMi           i 

4      I 

■  J     jj&illM^f                                   • 

W 

PM                      1 

Fig.   151. — Effects  of  Periostitis  on  the  Pedal  and  Navicular 

Bones. 


by  this  bony  deposit,  which  extended  on  to  the  os  pedis, 
causing  complete  anchylosis  at  each  extremity  of  the 
navicular.  The  lateral  cartilages  were  healthy.  The  in- 
teresting points  in  connection  with  the  case  are  the 
insidious  commencement  of  osseous  disease,  its  extensive 
development,  and  the  entire  absence  of  any  external  mani- 
festation, through  its  being  confined  entirely  within  the 
limits  of  the  hoof. 


392         DISEASES  OF  THE  HORSE'S  FOOT 

'  It  should  also  be  noted  that  the  animal  was  able 
to  undergo  a  severe  course  of  training  for  some  years,  and 
to  gallop  successfully  over  some  of  the  most  trying  courses 
in  England.  During  the  whole  of  this  time  he  walked  and 
galloped  apparently  sound,  but  trotted  always  lame,  and 
generally  dead  lame.'* 

2.  '  I  herewith  send  you  photographs  of  three  cases 
of  the  above  disease,  occurring  in  the  internal  surfaces  of 
ihe  wings  of  the  os  pedis.  The  photos  were  kindly  done 
for  me  by  Dr.  A.  Lingard,  Imperial  Bacteriologist  to 
Government  of  India.  It  is  a  cause  of  many  cases  of 
obscure  foot  lameness  in  India,  and  frequently  accounts  for 


Fig.   152.— Effects  of  Periostitis  on  the  Os  Pedis. 


the  numerous  entries  on  veterinary  medical  history  sheets 
under  the  heading  "  Contused  Foot." 

'  The  course  of  the  disease  is  as  follows :  The  disease 
makes  its  appearance  very  soon  after  arrival  in  India,  the 
animal  being  admitted  to  hospital  suffering  with  undoubted 
foot  lameness,  generally  slight.  One  is  soon  led  to  suspect 
this  disease  by  negative  symptoms  of  other  disease  being 
in  existence.  No  coronary  enlargement  or  flinching  on 
pressure  to  the  coronet,  no  shrinkage  or  wiring  in  of  the 
heels,  neither  is  the  characteristic  pointing  of  navicular 
present.       In  the  early  stages  one  has  false  hopes  of  re- 

*  W.  E.  Litt,  M.R.C.V.S.,  Veterinary  Record,  vol.  viii.,  p.  527. 


DISEASES  OF  THE  BOXES 


393 


covery  by  finding  gradual  improvement  for  a  time  by 
fomentation  and  poultices,  followed  by  irrigation  and 
stimulants  to  the  coronet,  and  perhaps  the  animal  is  dis- 
charged from  hospital,  to  be  returned  after  a  few  days 
worse  than  ever.  The  disease  then  becomes  insidious  and 
more  pronounced,  the  nodding  of  the  head,  even  at  a  walk, 
more  exaggerated,  and,  in  fact,  the  animal  seems  afraid  to 
put  his  foot  to  the  ground,  and  much  resembles  a  horse 
with  an  abscess  in  his  foot,  either  from  prick  or  picked  up 
nail.  He  absolutely  nurses  his  foot.  There  is  a  certain 
amount  of  heat  always  present.  The  disease  being  now 
well    developed,    pressure    is    caused   by    the    ends    of    the 


Fig.    153.— Effects  of  Periostitis  on  the  Os   Pedis. 


navicular  bone,  and  they  become  involved  at  their  points 
by  bony  deposits.  The  causes  of  this  disease  I  attri- 
bute, firstly,  to  hereditary  predisposition ;  and,  secondly 
the  exciting  cause,  standing  confined  on  board  ship, 
where  no  doubt  pedal  congestion  takes  place.  And 
perhaps  some  subjects  start  it  in  their  marches  in 
mobs  down  country  in  Australia.  Concussion  may  be 
the  cause  among  older  horses,  but  the  specimens  photo- 
graphed were  taken  from  remounts,  that  had  either  done 
no  work  or  only  very  gentle  work,  in  a  deeply  littered 
riding  school. 

'  Treatment. — It    is   obvious    from    the   position    of    ihis 


394        DISEASES  OF  THE  HORSE'S  FOOT 

disease  that  treatment  will  be  of  no  avail  in  producing  a 
cure.     As  already  stated,  the  disease  is  insidious  and  pro- 


Fig.   154.— Effects  of  Periostitis  on  the  Os  Pedis. 


Fig.   155.— Effects  of  Periostitis  on  the  Os  Pedis. 


gressive,  and  it  is  hopeless  to  expect  to  arrest  the  growths 
once  thev  are  started.     Unnerving-  would  no  doubt  remove 


DISEASES  OF  THE  BOXES  395 

the  symptom  ( lameness  )  of  the  disease,  but  an  unnerved 
horse  is  not  of  much  good  for  army  purposes.  I  therefore 
consider  that  once  the  disease  becomes  firmly  established 
it  is  an  unfortunate  and  incurable  one. 

'  Post-mortem  reveals  the  small  nodular  growths  on  the 
inner  surfaces  of  the  wings  of  the  pedal  bone,  and  if  long 
established  the  ends  of  the  navicular  bone  are  also  involved. 
Exudation  and  gradual  growth  of  false  material  around 
the  nodules  take  place,  which  also  serves  to  increase 
pressure.'* 

3.  '  This  case  was  brought  for  my  opinion.  The  horse 
was  lame,  and  walked  similar  to  one  that  had  had  lami- 
nitis,  putting  the  heel  down  first  upon  the  ground.  I 
ordered  the  patient  to  be  destroyed.  You  will  note  the 
ossification  of  the  flexor  pedis  at  its  attachment  to  the 
pedal  bone.  I  enclose  photos  of  the  ground,  also  of  the 
articular,  surfaces  of  the  bone.'t 


B.    PYRAMIDAL  DISEASE,  BUTTRESS  FOOT,  OR  LOW 
RINGBONE. 

Definition. — A  condition  of  periostitis  and  ostitis  in  the 
region  of  the  pyramidal  process  of  the  os  pedis,  usually 
preceded,  but  sometimes  followed,  by  fracture  of  the  pro- 
cess, and  characterized  by  deformity  of  the  hoof  and  an 
alteration  in  the  normal  angle  of  the  joint. 

Causes. — In  the  majority  of  cases  buttress  foot  is  brought 
about  by  fracture  of  the  pyramidal  process.  Thus,  although 
distinct  evidence  of  such  is  nearly  always  wanting,  we  may 
assume  that  the  original  cause  is  violent  injury  to  the  part 
in  question.  Properly,  therefore,  one  would  say  that  this 
condition  should  be  described  under  Fractures  of  the  Os 
Pedis.  It  appears,  however,  that  other  cases  of  the  kind 
arise  in  which  fracture  is  altogether  absent,  or  in  which  it 

*  Captain  L.  M.  Smith,  A.V.D.,  Veterinary  Record,  vol.  xi., 
p.  229. 

t  F.  B.  Jones,  M.R.C.V.S.,  Veterinary  Record,  vol.  xi.,  p.  230. 


396        DISEASES  OF  THE  HORSE'S  FOOT 

is  plainly  seen  to  be  subsequent  to  the  diseased  processes 
in  the  bone.  For  that  reason,  and  also  for  the  reason  that 
the  condition  has  come  to  be  known  by  the  name  we  have 
given,  we  give  it  special  mention. 

Symptoms  and  Diagnosis. — Even  when  the  condition 
arises  as  the  result  of  fracture,  the  ordinary  manifestations 
of  such  a  lesion  are  absent.  By  reason  of  the  situation  of 
the  parts  within  the  hoof  we  are  unable  to  detect  crepita- 
tion, and  the  resulting  lameness  is  perhaps — in  fact,  nearly 
always  is — neglected  until  such  time  as  any  heat  or  swell- 
ing caused  by  the  injury  has  disappeared,  in  which  case  we 
are  denied  what  evidence  we  might  have  obtained  from 
that.  All  that  is  presented  is  lameness,  and  lameness  that 
is  at  times  excessive.  But  with  the  lameness  there  is  noth- 
ing distinctive.  The  foot  is  tender  on  percussion,  and  the 
gait  suggestive  of  foot  lameness,  that  is  all.  We  are  unable, 
therefore,  to  make  an  exact  diagnosis,  and  the  condition 
goes  for  some  time  undetected. 

Later,  however,  changes  in  the  form  of  the  hoof  and 
the  coronet  begin  to  appear.  The  skin  of  the  coronet, 
especially  in  the  region  of  the  toe,  becomes  more  or  less 
thickened  and  indurated,  and  the  same  remark  applies  to 
the  subcutaneous  tissues.  The  most  marked  change,  how- 
ever, is  the  alteration  in  the  shape  of  the  hoof.  The  wall 
protrudes  at  the  toe  in  a  manner  that  has  been  termed 
'  buttress-like,'  and  has  given  to  the  condition  one  of  its 
names.  This,  of  course,  entirely  alters  the  contour  of  the 
horny  box.  From  being  more  or  less  U"snaPe(^>  **  ap- 
proaches nearer  the  formation  of  the  letter  V>  the  point  of 
the  V  being  at  the  toe. 

In  the  later  stages  the  coronary  enlargement  is  plainly 
seen  to  be  due  to  an  extensive  formation  of  bone.  It  is,  in 
fact,  a  reparative  callus,  and  the  reason  it  reaches  so  large 
a  size  is  probably  to  be  accounted  for  by  the  pull  of  the 
extensor  pedis  upon  the  detached  pyramidal  process.  As 
might  be  expected,  this  displacement  of  the  fractured  por- 
tion, with  its  effect  of  giving  greater  length  to  the  extensor 
pedis,  leads  to  a  backward  displacement  of  the  os  coronae 


DISEASES  OF  THE  BONES  397 

upon  the  pedal  bone.  As  a  result  there  is  a  marked  de- 
pression at  the  coronet,  the  depression  being  heightened 
in  effect  by  the  exostosis  in  front.  Pyramidal  disease  is, 
as  a  rule,  met  with  in  the  hind-feet,  but  occurs  also  in  the 
fore. 

Pathological  Anatomy. — When  occurring  without  frac- 
ture, the  first  ooservable  change  is  a  thinning  of  the  arti- 
cular cartilage  of  the  pyramidal  process,  through  which  the 
bone  beneath  appears  abnormally  white.  Later  the  thin- 
ning of  the  cartilage  progresses  until  at  last  it  becomes 
entirely  obliterated.  This  destruction  of  the  cartilage  com- 
mences first  at  the  highest  point  of  the  articular  surface  of 
the  pyramid,  and  gradually  reaches  further  backward  into 
the  joint.  While  this  is  taking  place  the  new  bone  is  being 
formed  on  the  front  of  the  os  pedis,  below  and  around  the 
process,  until,  as  we  have  already  seen,  an  exostosis  is 
formed,  large  enough  to  be  noticeable  at  the  coronet.  This, 
of  course,  partly  implicates  the  joint  and  the  points  of  the 
insertion  of  the  extensor  tendon. 

Finally,  fracture  may,  or  may  not,  take  place.  When  it 
does  the  exostosis  is  larger,  and  the  general  deformity  of 
the  hoof  greater. 

Treatment. — Ordinary  treatment,  such  as  point  or  line 
firing,  repeated  blisters,  or  hoof  section,  each  of  which  we 
have  tried,  appears  to  be  utterly  useless.  So  far  as  we 
have  been  able  to  gather  from  the  writings  of  other  prac- 
titioners, however,  neurectomy  returns  the  animal  for  a 
time  to  usefulness.  If  the  fore-limb  is  the  seat  of  trouble, 
either  plantar  or  median  neurectomy  may  be  practised ;  if 
the  hind,  then  the  best  results  are  obtained  by  section  of 
the  posterior  tibial. 

Reported  Cases. — 1.  'This  animal,  a  mare,  had  been 
rested  for  lameness  behind  for  two  or  three  weeks,  and 
then  sent  out  to  work,  going  sound.  This  was  repeated 
several  times,  and  each  time  the  coachman  reported,  "  Goes 
very  lame  behind  after  she  has  been  at  work  about  fifteen 
to  twenty  minutes."  She  always  pulled  out  sound  when  I 
saw  her  in  a  halter  on  the   following  day,   so  I  had  her 


398         DISEASES  OF  THE  HORSE'S  FOOT 

ridden,  and  after  about  seven  or  eight  minutes  she  began 
to  go  lame  in  a  hind-limb.  Her  lameness  got  rapidly  worse 
as  she  was  being  ridden,  and  within  a  quarter  of  mile  of 
her  first  showing  lameness,  she  dropped  and  carried  the 
lame  foot  in  a  way  that  suggested  a  badly  fractured  pastern. 
There  was  no  recognisable  disease  in  the  limb  to  account 
for  this  lameness. 

'  I  divided  the  posterior  tibial  nerve,  and  she  went  back 
to  work  moving  sound,  and  continued  to  work  sound  up  to 
her  death  from  one  of  the  regularly  fatal  bowel  lesions — 
twist  or  rupture. 

'  She  worked  nearly  two  years  after  unnerving,  and 
developed  the  usual  thickening  at  the  coronet.'* 

2.  '  The  subject  of  this  note  was  a  chestnut  mare,  nine 
years  old,  and  used  for  omnibus  work. 

'  History. — For  about  two  months  the  mare  was  lame 
on  the  off  fore-leg,  and  in  spite  of  treatment  the  con- 
dition became  steadily  worse.  The  off  fore-foot  was' 
rather  long  and  narrow,  and  the  fetlock-joint  was  inclined 
to  be  bowed  outwards,  but  the  degree  of  lameness  was  out 
of  proportion  to  these  defects,  and  the  diagnosis  was 
obscure. 

■  Median  neurectomy  was  performed  on  May  10,  1902, 
and  reduced  the  lameness  to  about  half  of  what  it  was 
before.  On  June  5  ulnar  neurectomy  was  performed,  with 
the  result  that  the  mare  became  sound,  and  went  to  work 
three  weeks  later.  She  continued  to  work  soundly  and 
well,  being  inspected  from  time  to  time. 

'  During  February  of  1903  the  coronet  began  to  enlarge 
if  front  and  slightly  to  the  outer  side,  and  gradually 
a  ridge  of  bone  grew  down  from  the  coronet  to  the  toe. 
The  case,  in  fact,  became  a  typical  one  of  so-called  "  but- 
tress foot,"  which  my  friend  Mr.  Willis  has  described  as 
diagnostic  of  disease  of  the  pyramidal  process  of  the  pedal 
bone.  Meanwhile  the  swelling  of  the  coronet,  which  ap- 
peared to  be  mainly  composed  of  fibrous  tissue,  increased  in 

*  W.  Willis,  M.R.C.V.S.,  Journal  of  Comparative  Pathology  and 
Therapeutics,  vol.  xv.,  p.  366. 


DISEASES  OF  THE  BONES 


399 


size,  until  the  whole  of  the  front  and  sides  became  involved, 
assuming  the  appearance  shown  in  Fig.  156. 

'  In  spite  of  the  coronary  enlargement  the  mare  worked 
well,  and  remained  free  from  lameness  till  June  8,  1903,  on 
which  day  the  limb  became  swollen  up  to  the  site  of  the 


Fig.   156.— A   Case   of  Buttress  Foot. 


median  operation.  The  appearance  of  the  limb  closely 
simulated  an  attack  of  lymphangitis.  The  mare  was  kept 
under  observation  till  the  13th  of  the  same  month,  during 
which  time  the  swelling  increased,  as  did  also  the  lameness 
to  a  slight  degree.        During  progression   she  brought  the 


400 


DISEASES  OF  THE  HORSE'S  FOOT 


heel  to  the  ground  and  ''rocked  the  toe,"  as  in  a  case  of 
rupture  of  the  perforans  tendon.  The  mare  was  killed  on 
June  13. 

'  Post-mortem. — In  trying  to  pull  away  the  hoof  from  the 


Fig.    157. — Fracture   of  the   Pyramidal    Process  in  Buttress 

Foot. 

sensitive  structures  wtih  a  pair  of  farrier's  pincers,  the 
tendons  and  ligaments  of  the  corono-pedal  articulation  gave 
way,  leaving  the  pedal  bone  in  situ.  The  flexor  perforans 
tendon  showed  inflammatory  softening,  and  was  very  nearly 
ruptured  through  at  the  level  of  the  navicular  bone.    There 


DISEASES  OF  THE  BONES  401 

was  slight  evidence  of  navicular  disease.  The  articular 
cartilage  of  the  corono-pedal  joint  has  been  almost  com- 
pletely removed,  and  there  was  sclerosis  of  the  opposed 
bony  surfaces,  which  by  unequal  wear  had  brought  about 
deformity  of  the  os  coronae  and  os  pedis. 

There  was  very  old-standing  fracture  of  the  pyramidal 
process  (see  Fig.  157),  with  the  formation  of  a  false  joint 
between  the  process  and  the  pedal  bone.  There  was  also  a 
recent  fracture  of  the  part  of  the  pedal  bone  which  carries 
the  articulation  for  the  navicular  bone,  and  this  and  the 
tendon  lesions  probably  accounted  for  the  final  symptoms 
of  '  break-down/ 

Neurectomy  enabled  us  to  get  a  year's  useful  work  out 
of  what  would  otherwise  have  been  a  hopeless  cripple.* 


C.    FRACTURES  OF  THE  BONES. 

More  or  less  by  reason  of  the  protection  afforded  them 
by  the  hoof  fractures  of  the  bones  of  the  foot  are  rare. 
When  occurring  they  are  more  often  than  not  the  result  of 
direct  injury,  as,  for  example,  violent  blows,  the  trapping 
of  the  foot  in  railway  points,  the  running  over  of  the  foot 
with  a  heavily-laden  waggon,  or  violent  kicking  against  a 
gate  or  a  wall.  They  occur  also  as  a  result  of  an  uneven 
step  upon  a  loose  stone  when  going  at  a  fast  pace,  and  as 
a  result  of  sudden  slips  and  turns,  in  which  latter  case  they 
are  met  with  when  animals  have  been  galloping  unrestrained 
in  a  field,  or  when  an  animal,  ridden  or  driven  at  a  fast 
pace,  is  suddenly  pulled  up,  or  just  as  suddenly  turned. 

At  other  times  fractures  in  this  region  take  place  without 
ascertainable  cause,  and  cases  are  on  record  where  animals 
turned  overnight  into  a  loose  box  in  their  usual  sound 
condition  have  been  found  in  the  morning  excessively  lame, 
and  fracture  afterwards  diagnosed. 

*  A.  R.  Routledge,  M.R.C.V.S.,  Journal  of  Comparative  Pathology 
and   Therapeutics,  vol.  xvi.,  p.  371. 


402         DISEASES  OF  THE  HORSE'S  FOOT 

1.    Fractures  of  the  Os  Corona. 

Fractures  of  the  os  coronae  result  from  such  causes  as  we 
have  just  enumerated,  and  are  nearly  always  seen  in  con- 
junction with  fractured  os  suffraginis.  When  this  latter 
bone  is  also  fractured  diagnosis  is  comparatively  easy,  a 
certain  amount  of  crepitus,  even  when  the  suffraginis  is 
only  split,  being  obtainable.  When  the  os  coronse  alone  is 
fractured  then  diagnosis  is  extremely  difficult,  the  small- 
ness  of  the  bone  and  the  comparative  rigidity  of  the  parts 
rendering  manipulation  almost  useless,  and  effectually 
preventing  the  obtaining  of  crepitus.  It  is,  in  fact,  only 
when  the  bone  is  broken  into  many  pieces  that  crepitus 
may  be  detected,  and  even  then  it  is  slight. 

Reported  Cases. — 1.  '  The  subject  was  a  four-year  old 
hunter.  While  at  exercise  in  the  morning  of  August  10  he 
bolted,  got  rid  of  his  rider,  and  ran  about  in  a  mad  fashion, 
came  into  contact  with  a  wheelbarrow  in  a  narrow  passage, 
and  finally  came  into  violent  contact  with  a  wall,  which  had 
the  effect  of  throwing  him  down.  The  rider  stated  that  the 
animal  suddenly  put  down  his  head  and  managed  to  get  off 
the  bridle ;  he  then  bolted,  and  the  only  chance  for  the  rider 
was  to  throw  himself  off. 

'  On  examination  I  found  the  horse  unable  to  place  any 
weight  on  the  off  fore-leg,  the  pastern  was  swollen  and 
painful,  the  hollow  of  the  heel  was  also  swollen,  and  there 
was  marked  constitutional  disturbance. 

'  After  a  short  time  he  would  place  the  heel  on  the 
ground  and  elevate  the  toe  to  a  slight  degree.  On  manipu- 
lating the  pastern  slight  crepitation  could  be  discovered, 
and  there  was  abnormal  mobility  in  the  corono-pedal  arti- 
culation. On  the  near  fore-leg  there  were  extensive 
wounds  in  the  region  of  the  knee,  and  great  laceration  of 
the  tissues.     The  animal  was  destroyed. 

'  On  examining  the  leg  I  found  the  subcutaneous  tissues 
infiltrated  from  below  the  knee  to  the  foot,  large  masses  of 
gelatinous  blood-stained  material  being  present  along  the 
flexor  tendons  and  in  the  hollow  of  the  heel.     The  inferior 


DISEASES  OF  THE  BOXES  403 

articular  surface  of  the  os  suffraginis  was  denuded  of  carti- 
lage anteriorly ;  the  os  coronae  was  fractured  into  eight 
moderate  sized,  irregular  fragments,  and  ten  minute  pieces. 
The  surface  of  the  perforans  tendon  as  it  glides  over  the 
smooth  surface  at  the  back  of  the  os  corome  was  lacerated, 
and  minute  portions  of  the  bone  were  found  embedded 
therein.'* 

2.  '  Here,  again,  fracture  was  the  result  of  the  animal 
bolting  with  his  rider.  Trying  to  avoid  collision  with  a 
conveyance  coming  towards  him,  the  animal  slipped  on  a 
wooden  pavement,  sliding  along  until  his  near  fore-leg  came 
in  contact  with  the  wheel  of  a  standing  cab.  There  was 
considerable  swelling  from  the  knee  downwards,  great  pain, 
and  evidence  of  fracture  in  the  region  of  the  pastern. 

1  Post-mortem  revealed  the  os  suffraginis  broken  into 
about  thirty  pieces,  and  the  os  corome  with  a  piece  broken 
off  the  inside  of  its  proximal  end.'t 

3.  '  The  patient  was  a  brown  mare  used  for  heavy  van 
work  in  London.  About  January  10  she  was  lame,  and  as 
she  had  a  cracked  heel,  was  treated  by  poulticing  for  a  day, 
and  then  by  antiseptic  lotions.  In  a  week  she  was  sent  to 
work,  but  the  following  day  lameness  returned,  and  con- 
tinued till  about  February  15.  Xo  special  symptom  was 
detected  which  indicated  the  exact  position  of  any  cause  of 
lameness.  Then  the  lameness  increased  in  severity,  and 
some  swelling  around  the  coronet  began  to  show  itself. 

'  In  consultation  with  another  veterinary  surgeon,  two 
possible  causes  of  this  intense  lameness  were  discussed: 
one,  that  we  had  septic  infection  of  the  coronet,  and  that 
probably  the  swelling  of  this  part  would  soften,  and  sloughs 
occur ;  the  other,  that  a  fracture  of  the  os  pedis  or  os 
coronse  existed.  The  enlargement  of  the  coronet  was  hard 
and  firm,  not  particularly  sensitive.  It  was  decided  to  do 
nothing  for  a  few  days.     In  a  week  the  pain  abated,  and 

*  E.  Wallis  Hoare,  F.R.C.V.S.,  Veterinary  Record,  vol.  xiv., 
p.   i33. 

t  A.  F.  Appleton,  M.R.C.V.S.,  Veterinary  Journal,  vol.  xiii., 
p.  411. 


404        DISEASES  OF  THE  HORSE'S  FOOT 

the  mare  would  put  her  foot  on  the  ground,  and  ceased  to 
"  nurse  "  the  limb  as  she  had  done.  When  moved  over  in 
the  box  she  put  a  little  weight  on  the  foot,  but  limped  very 
decidedly. 

'  Another  week  passed,  and  the  pain  and  lameness  further 
abated,  but  the  swelling  around  the  coronet  continued. 
Perhaps  it  was  a  little  less  in  front,  but  it  had  not  decreased 
on  the  inside.     It  remained  firm,  and  was  not  painful  on 


Fig.  158. — Fracture  in  Situ  (Os  Coronae). 


pressure.     It  showed  no  soft  places,  and  the  upper  part  of 
the  leg  remained  free  from  oedema. 

'  The  diagnosis  was  now  that  a  fracture  existed,  and  it 
was  proposed  to  send  the  mare  to  grass  for  a  few  months. 
The  consulting  veterinary  surgeon  suggested  that  before 
doing  so  a  blister  might  be  applied  to  the  coronet.  This 
was  done.  The  mare  was  found  next  day  again  on  three 
legs.     She   had    apparently   been   down   during   the   night. 


DISEASES  OF  THE  BONES 


405 


In   a   few   days   the   coronet  increased   again   in   size,   and 
within  a  week  "  broke  out  "  in  two  places. 

'  The  opinion  now  formed  was  that,  with  a  fracture  and 
this  additional  cause  of  inflammation  around  the  joint,  it 
would  be  most  economical  for  the  owner  to  have  her  killed. 
This  was  done,  and  a  post-mortem  examination  was  made 
by  Air.  Hunting  and  Air.  Willis. 


Fig.   159. — With  Broken  Portion   Removed. 

'Post-mortem. — The  foot,  cut  off  at  the  fetlock-joint, 
showed  extensive  swelling  all  round  the  coronet.  There 
were  two  wounds  on  the  skin — one  on  the  front  of  the 
coronet,  the  other  on  the  inner  side.  From  both  pus  and 
blood  had  escaped.  They  both  communicated  under  the 
skin  and  with  a  large  abscess  cavity.  The  abscess  did  not 
communicate  with  the  joint.  The  pastern  bone  was  sound. 
On  separating  the  pastern  from  the  coronet  bone  the 
articular  surfaces  were  of  a  healthv  colour,  but  the  soft 


406         DISEASES  OF  THE  HORSE'S  FOOT 

tissues  immediately  surrounding  them  were  inflamed.  On 
the  centre  of  the  articular  surface  of  the  coronary  bone 
a  thin  red  wing  was  noticed,  and  the  portion  of  cartilage 
within  it  seemed  raised.  With  the  point  of  a  scalpel  this 
portion  was  lifted,  and  was  found  to  be  not  only  cartilage, 
but  a  layer  of  bone  completely  detached  from  the  os  coronae. 
On  removing  the  bones  from  the  hoof  the  rest  of  the  bone 
was  quite  normal,  as  was  the  pedal  bone. 

'  Fig.  158  shows  the  articular  surface  of  the  coronet  with 
the  fracture  in  situ;  and  Fig.  159  the  surface  from  which 
the  broken  portion  is  removed  and  laid  to  the  side  of  the 
foot. 

'  Some  interesting  questions  arise.  How  was  the  fracture 
caused?  When  did  it  occur?  Between  the  broken  portion 
and  the  main  bone  there  was  a  layer  of  granulation  tissue, 
so  that  it  is  certain  the  injury  existed  before  the  blister 
was  applied,  and  it  may  possibly  have  existed  from  the 
commencement  of  the  lameness.'* 

2.    Fractures  of  the  Os  Pedis. 

These  also  are  a  result  of  the  causes  we  have  before 
given.  The  os  pedis  is  also  liable  to  fractures  from  pricks, 
from  treads  in  the  region  of  the  wings,  and  from  the  mal- 
nutrition and  careless  use  of  the  foot  sometimes  following 
neurectomy. 

It  is  interesting  to  note  that,  with  fracture  of  this  bone, 
lameness  is  nearly  always  excessive,  but  that  at  times  it 
may  be  entirely  absent.  Crepitus  is,  of  course,  denied  us, 
and  in  nearly  every  instance  the  case  is  only  diagnosed 
when  the  lameness  persists  and  pus  commences  to  form,  or 
when  grave  changes  in  the  normal  shape  of  the  foot  compel 
our  attention  to  the  parts.  When  it  is  the  continued  forma- 
tion of  pus  that  draws  our  notice  to  something  more  than 
ordinarily  grave,  it  is  in  giving  exit  to  the  pus  that  the 
fracture  is  nearly  always  discovered. 

Reported  Cases. — Two  interesting  cases  of  fractured  os 
pedis  are  reported  by  Mr.  Gladstone  Mayall,  M.R.C.V.S., 
in  the  Jreterinary  Record,  vol.  xiv.,  p.  54: 

*  R.  Crawford,  M.R.C.V.S.,  Veterinary  Record,  vol.  viii.,  p.  478. 


DISEASES  OF  THE  BOXES 


407 


pedis  are  reported  by  ^\Ir.  Gladstone  ]\Layall,  M.R.C.V.S., 
in  the  Veterinary  Record,  vol.  xiv.,  p.  54: 

1.  '  The  horse  was  brought  in  markedly  lame  on  the  off 
hind-foot,  knuckling  at  the  fetlock,  and  taking  a  long  stride 
with  the  injured  limb.  There  was  a  punctured  wound  at 
the  toe.  The  horn  was  pared,  and  antiseptic  poultices 
applied.  Notwithstanding  the  antiseptic  treatment  pus  con- 
tinued to  form.  At  the  end  of  a  week  sufficient  horn  was 
removed  to  ascertain  the  cause  of  the  constant  suppuration. 
A  movable  object  was  found  at  the  bottom  of  the  wound, 
and  a  piece  of  bone  as  large  as  a  sixpence  finally  removed. 
Recovery  was  uneventful.' 


'&>  v!  Pu  « - 


Fig.   160.— Fractured   Os  Pedis. 

2.  '  A  filly  was  attended  for  a  discharging  fistula  at  the 
coronet.  Externally  it  had  all  the  appearances  of  a  quittor. 
At  first  no  history  was  given.  The  filly  went  scarcely  lame 
ai  all,  and  had  never  been  shod.  Treatment  with  poultices 
and  caustic  injections  was  useless.  Finally  the  filly  was 
cast  and  the  foot  examined.  A  piece  of  bone,  apparently 
part  of  the  wing  of  the  os  pedis,  was  removed,  and  the  case 
made  a  good  recovery.  Subsequent  inquiries  elicited  the 
fact  that  the  animal  had  kicked  at  and  hit  a  gate-post,  and 
ii  was  judged  that  then  the  injury  had  occurred." 

3.  '  The  subject  was  a  bay  horse,  nine  years  old.  used 
for  railway  shunting.     On  August  7  he  was  found  to  be  in- 


408        DISEASES  OF  THE  HORSE'S  FOOT 

tensely  lame  of  the  near  hind-limb,  and,  after  inquiries, 
there  was  no  evidence  bearing  on  the  cause,  as  is  often 
the  case,  and  at  times  this  comes  to  light  when  least 
expected. 

4  I  was  called  in  consultation  on  September  2,  and  found 
him  suffering  acute  pain,  with  great  swelling  around  the 
coronet.  The  foot  was  examined  thoroughly,  and  the  diag- 
nosis was  fracture  of  the  pedal  bone,  and  immediate  slaugh- 
ter was  recommended.  However,  that  was  not  carried  out, 
and  he  died  on  September  22. 

'  The  post-mortem  inspection  revealed  a  complete  fracture 
of  nearly  the  whole  of  the  articulating  surface  and  the  left 
wing  of  the  pedal  bone  (as  shown  in  Fig.  160).'* 

4.  A  further  interesting  case  is  reported  by  Mr.  William 
Hurrell.t  Here  the  cause  was  presumably  galloping  in  the 
field,  for  the  subject,  a  cart  mare  running  out  at  grass  with 
her  foal,  was  suddenly  found  to  be  lame. 

As  the  lameness  continued  to  increase  in  severity,  Mr. 
Flurrell  was  called  in  on  August  1,  and  diagnosed  the  case 
as  one  of  foot  lameness.  On  this  date  the  foot  was  pared' 
out,  and  a  large  accumulation  of  pus  discovered.  Poul- 
ticing and  antiseptic  dressings  were  continued  until  August 
lo,  when  a  movable  piece  of  the  os  pedis  was  found  at 
the  toe. 

On  August  25  this  detached  portion  of  the  bone  was  re- 
moved, and  turned  out  to  be  the  whole  of  the  anterior 
margin  of  the  os  pedis,  measuring  3^  inches  long,  and  vary- 
ing in  width  from  i  inch  to  H  inches.  On  September  20 
the  mare  was  working  without  lameness. 

3.    Fractures  of  the  Navicular  Bone. 

Hidden  within  the  wings  of  the  os  pedis,  and  protected 
as  it  is  by  its  tendinous  covering  and  the  yielding  substance 
of  the  plantar  cushion,  the  navicular  bone  is  even  less  liable 
to  fracture  than  either  of  the  other  bones  of  the  foot. 

The  most  common  cause  of  fracture  of  the  navicular  is 

*  J.  Freeman,  M.R.C.V.S.,  Veterinary  Journal,  vol.  xxxi.,  p.  324. 
t  Ibid.,  vol.  v.,  p.  408. 


DISEASES  OF  THE  BONES  409 

that  of  stabs  or  deep  pricks  in  the  region  of  the  point  of  the 
frog  (see  p.  216).  Following  that,  the  next  most  common 
cause  is  violent  injury.  We  thus  find  the  navicular  bone 
fractured,  together  with  one  or  both  of  the  other  bones  of 
the  foot,  when  the  foot  is  run  over  by  a  heavy  vehicle.  One 
such  case  is  reported  by  Mr.  J.  H.  Carter,  F.R.C.V.S.,  where 
the  horse's  foot  was  run  over  by  a  tram-engine,  in  which  the 
os  pedis  and  the  navicular  were  fractured  in  several  places.* 
A  further  case  is  on  record  where  a  sharp  blow  on  the  front 
of  the  hoof  was  the  cause.  In  this  case  the  os  pedis  and 
other  structures  were  uninjured,  but  the  navicular  bone  was 
fractured  into  three  large,  and  about  half  a  dozen  small 
pieces,  t 

Fractures  of  the  navicular  may  occur,  however,  in  which 
history  of  a  prick  or  of  a  violent  injury  is  absent.  See 
reported  case  below. 

As  with  fractures  of  the  os  pedis  and  the  os  coronse,  so 
with  this  exact  diagnosis  is  difficult — we  may  say  almost  im- 
possible. With  a  history  of  violent  injury,  however,  some 
little  regard  may  be  paid  to  a  continued  heat  and  tenderness 
of  the  foot,  and  a  distinct  inclination  on  the  part  of  the 
animal  to  go  on  the  toe.  Even  when  the  fracture  is  the 
result  of  a  prick,  and  the  bone  is  plainly  felt  with  the  probe, 
we  still  cannot  be  positive  as  to  fracture. 

Reported  Case. — '  The  animal  was  a  Hungarian,  a  troop- 
horse  in  the  3rd  Hussars  ( G.  15).  On  November  22,  1881. 
on  the  march  from  Norwich  to  Aldershot,  the  horse  sud- 
denly made  a  violent  stumble,  very  nearly  coming  on  to  his 
knees.  The  rider  declared  that  he  put  his  foot  on  a  stone. 
The  accident  caused  great  lameness  in  the  near  fore-leg,  and 
and  the  horse  had  to  be  led  the  remainder  of  that  day's 
march.  On  the  following  day  he  was  also  led ;  but,  after 
going  some  sixteen  or  eighteen  miles,  he  was  so  lame  that  he 
was  left  at  the  nearest  billet  (in  Edmonton).  He  was  here 
attended  by  Air.  Stanley,  M.R.C.V.S.,  of  Edmonton,  who 
pronounced  it  a  case  of  navicular  disease.     I  first  saw  the 

*  Veterinary  Journal,  vol.  xxxi.,  p.  246. 
t  Veterinarian  for  1857,  p.  ~3. 


410         DISEASES  OF  THE  HORSE'S  FOOT 

animal  on  December  1,  1881,  and  quite  agreed  with  Mr. 
Stanley  that  it  was  a  case  of  foot  lameness,  though,  from 
the  horse's  former  history,  I  could  not  think  it  a  case  of 
ordinary  navicular  disease.  I  diagnosed  it  a  case  of  frac- 
ture, without  displacement,  either  of  the  os  coronse  or  the 
navicular  bone,  but  was  more  inclined  to  the  former  than 
the  latter.  This  was  after  a  full  hour's  examination.  I 
failed  to  find  any  heat  in,  or  any  flinching  by  manipulation 
of,  any  part  of  the  limb ;  but,  in  walking,  the  horse  was  ex- 
cessively lame,  going  on  the  toe,  and,  indeed,  trying  if  pos- 
sible to  keep  the  foot  entirely  off  the  ground. 

'  On  December  6  the  horse  was  sent  on  to  Aldershot  by 
rail.  He  was  then  walking  better,  though  still  very  lame. 
My  only  treatment  for  a  short  time  was  to  apply  cold  water 
constantly  to  the  coronet  and  foot.  For  two  hours  daily 
this  was  done  by  a  hose,  the  remainder  of  the  time  by  a 
cold  swab.  On  December  14  I  applied  a  strong  blister  over 
the  coronet,  reaching  up  to  the  fetlock.  This  was  washed 
off  about  the  end  of  December.  The  horse  was  then  not 
nearly  so  lame.  I  then  resumed  the  cold-water  treatment, 
and  he  got  gradually  better,  and  was  sent  to  light  duty  on 
February  18,  1882.  He,  however,  only  attended  one  field- 
day,  and  was  taken  into  the  Horse  Infirmary  again  on 
March  8,  very  lame.  Again,  there  was  an  entire  absence 
of  heat  or  pain  on  pressure,  but  the  same  action,  viz.,  going 
on  the  toe.  I  forgot  to  remark  that  he  always  pointed  the 
toe  of  the  affected  leg  when  standing  in  the  stable,  and  this 
symptom  continued.  I  put  him  under  the  cold-water  treat- 
ment for  a  short  time,  and  about  the  middle  of  March  again 
applied  a  strong  blister  over  the  coronet  up  to  the  fetlock. 
This  was  washed  off  about  the  end  of  the  month,  and  was 
succeeded  by  the  cold  water  again.  Towards  the  end  of 
April  there  was  no  improvement  at  all,  and  I  applied  for 
permission  to  destroy  the  horse.  This  was  carried  out  on 
April  27,  at  the  recommendation  of  Mr.  Gudgin,  I.V.S., 
Aldershot,  and  a  Board  of  veterinary  surgeons. 

'  On  making  the  post-mortem  examination  I  first  thought 
the   bone   was   only   partly    fractured    or   cracked,    but   on 


DISEASES  OF  THE  BONES  411 

manipulating  it,  after  its  being  in  hot  water  a  short  time,  I 
saw  the  fracture  was  complete."1' 

Treatment  of  Fractures  of  the  Bones  of  the  foot. — It 
will  be  seen  at  once  that  in  most  cases  anything  in  the  way 
of  bandaging  is  well-nigh  useless.  When  the  os  coronse  is 
fractured,  however,  a  little  more  may  be  added  to  the 
natural  rigidity  of  the  parts  by  enclosing  the  region  of  the 
pastern  and  the  foot  in  a  plaster-of-Paris  bandage.  The 
main  treatment,  however,  in  every  case,  will  be  a  continual 
use  of  the  slings  for  at  least  seven  to  eight  weeks,  by  that 
means  compelling  the  animal  to  give  to  the  injured  parts 
the  necessary  amount  of  rest. 

With  fracture  of  the  os  pedis,  when  such  is  caused  by 
pricks  and  complicated  by  a  flow  of  pus,  then  attention 
must  be  given  to  removal  of  the  displaced  piece  of  bone. 
The  pus  track  is  to  be  followed  up  with  the  searcher,  suffi- 
cient horn  removed  with  the  knife,  and  the  broken  piece  of 
bone  removed  with  a  scalpel  and  a  pair  of  strong  forceps, 
the  operation  to  be  afterwards  followed  up  by  antiseptic 
dressings  to  the  opening.  Until  this  is  done  the  wound 
refuses  to  heal. 

Fracture  of  the  navicular  bone,  if  in  any  way  diagnosed 
with  certainty,  offers  us  an  almost  hopeless  case,  for  it 
appears  to  be  a  commonly  reported  fact  that  attempts  at 
reunion  are  rare.  This,  in  all  probability,  is  due  to  the 
pressure  put  upon  it  every  now  and  again,  when  the  animal's 
weight  presses  the  bone  between  the  os  coronae  and  the  os 
pedis  above  and  the  perforans  tendon  below.  Even  should 
reunion  take  place,  the  resulting  callus,  interfering  as  it 
does  with  the  movements  of  the  perforans,  leaves  us  a  case 
of  incurable  lameness.  Y\  nen  the  fracture  is  complicated 
by  the  formation  of  pus,  as  in  the  case  of  prick,  then  the 
case,  with  the  attendant  purulent  synovitis  and  arthritis,  is 
even  more  hopeless  still. 

Diagnosis  of  fracture  of  either  of  the  bones  of  the  foot  is, 
as  we  have  said  before,  extremely  difficult.     It  so  happens, 

*  S.  W.  Wilson,  M.R.C.Y.S.,  A.V.D..  Veterinary  Journal,  vol.  xv„ 

p.    12. 


412        DISEASES  OF  THE  HORSE'S  FOOT 

therefore,  in  those  cases  caused  by  violent  blows,  that  any- 
thing approaching  an  accurate  opinion  cannot  be  given  until 
some  months  after  the  injury.  After  some  time  we  are  met 
with  unmistakable  changes  in  the  form  of  the  foot,  and  are 
able  to  assume  that  the  persisting  lameness  is  due  to  pres- 
sure of  a  reparative  callus  within  the  hoof.  In  such  cases 
the  only  treatment  of  any  use  is  that  of  neurectomy. 


CHAPTER  XII 

DISEASES  OF  THE  JOINTS* 

A.    SYNOVITIS. 

Definition. — By  the  term  '  synovitis  '  is  indicated  an  inflam- 
mation of  the  synovial  membrane.  It  may  be  either 
(a  )Simple  or  Acute,  or  it  may  be  (b)  Purulent  or  Suppu- 
rative. 

In  the  simpple  form  there  is  little  or  no  tendency  for  the 
affection  to  implicate  the  other  structures  of  the  joint, 
whereas  in  the  suppurative  form  the  joint  capsule,  the 
ligaments,  and  the  bones  soon  come  to  participate  in  the 
diseased  processes,  giving  us  a  condition  which  we  shall 
afterwards  describe  as  acute  arthritis. 

(a)  Simple  Synovitis. 

1.  Acute — {Causes). — Simple  or  acute  synovitis  is  near- 
ly always  brought  about  by  injury  to  the  joint — by  blows 
or  bruises,  or  by  sprains  of  the  ligaments.  At  other  times 
it  occurs  without  ascertainable  cause,  and  is  then  put  down 
to  the  influence  of  cold,  or  to  poisonous  materials  ( as.  for 

*  Properly  speaking,  we  have  in  the  foot  of  the  horse  but  one 
joint — namely,  the  corono-pedal  articulation. 

Although  not  a  joint  in  the  strict  sense  of  the  word,  we,  never- 
theless, intend  here  to  consider  the  navicular  bursa  as  such.  In  this 
apparatus,  although  we  have  no  articular  cartilage  proper,  and  no 
apposition  of  bone  to  bone,  we  still  have  a  large  synovial  cavity, 
and  in  close  proximity  to  it  bone.  We  may,  in  fact,  and  do  get  in 
it  exactly  similar  changes  to  those  termed  'synovitis'  and  'arthritis' 
elsewhere.  Therefore,  we  include  the  changes  occurring  in  it  in  this 
chapter,  and  hence  the  plural  use  of  the  word  to  which  this  note 
refers. 


414        DISEASES  OF  THE  HORSE'S  FOOT 

example,  that  of  rheumatism)  circulating  in  the  blood- 
stream. 

Pathology. — Uncomplicated  acute  synovitis  never  causes 
death.  The  pathological  changes  in  connection  with  it  have 
therefore  been  studied  in  cases  purposely  induced,  and  the 
animal  afterwards  slaughtered.  It  is  then  found  that,  as 
in  inflammation  elsewhere,  the  synovial  membrane  is  show- 
ing the  usual  inflammatory  phenomena — that  it  is  thick 
and  swollen  as  a  result  of  the  inflammatory  hyperemia  and 
commencing  exudation.  Later,  the  synovial  fluid  becomes 
increased  in  quantity,  is  thin  and  serous,  and  after  a  time 
is  seen  to  be  mixed  with  the  inflammatory  exudation  poured 
into  it.  We  then  find  that  it  has  lost  its  clear  appearance, 
has  become  thick  and  muddy,  and  has  floating  in  it  flakes 
of  fibrin. 

If  the  case  progresses  favourably  these  materials  are  soon 
absorbed  and  resolution  occurs.  In  rarer  cases  the  thicken- 
ing and  congestion  of  the  membrane  increases,  and  the 
articular  capsule  becomes  so  distended  with  the  increased 
synovia  and  accumulated  inflammatory  discharges  that  a 
kind  of  chemosis  occurs.  In  other  words,  there  oozes 
through,  without  actual  rupture  of  the  membrane,  a  thin, 
blood-stained,  and  purulent-looking  discharge. 

It  is  an  important  point  to  note  that  in  cases  of  synovitis 
the  fringes  of  the  synovial  membrane  become  swollen  and 
blood-injected,  forming  noticeable  red  elevations  at  the 
margins  of  the  cartilages.  It  is  then  that  the  diseased  con- 
dition soon  spreads  and  runs  into  arthritis. 

Further,  it  is  important,  especially  with  regard  to  the 
question  of  the  degree  of  pain  and  lameness  likely  to  be 
caused,  to  note  that  often  granulations  are  thrown  out  upon 
the  looser  folds  of  the  membrane.  As  these  increase  in 
size  they  come  to  form  fringed  and  villous  membranous 
projections  inserting  themselves  between  the  bones  forming 
the  articulation.  In  such  cases  there  is  no  doubt  that  the 
intense  pain  sometimes  observed  in  these  cases  is  due  to 
pinching  of  these  prolongations  of  the  synovial  membrane 
by  the  opposing  bones  of  the  joint. 


DISEASES  OF  THE  JOINTS  415 

Symptoms  and  Diagiiosis. — Acute  synovitis  of  a  joint 
leads  to  heat  of  the  parts,  pain,  distension  of  the  capsule, 
and,  where  the  joint  may  be  easily  felt,  fluctuation.  In  the 
articulation  with  which  we  are  dealing,  however,  these  last 
two  symptoms  are  not  easily  detected,  for  the  surrounding 
structures — namely,  the  lateral  and  other  ligaments  of  the 
joint,  the  extensor  pedis  tendon  in  front,  and  the  perforans 
behind,  together  with  the  dense  and  comparatively  un- 
yielding nature  of  the  skin  of  the  parts — are  such  as  to 
prevent  distension  and  fluctuation  becoming  marked  to  a 
visible  extent.  We  are  able  to  diagnose  the  case  as  one  of 
foot  lameness,  and,  with  a  history  of  a  severe  blow  or  other 
injury,  are  able  to  assume  that  this  condition,  perhaps 
attended  with  periostitis,  is  in  existence. 

When  other  symptoms  present  themselves  diagnosis  may 
be  more  certain.  The  animal  becomes  slightly  fevered, 
throbbing  pains  in  the  joint  manifest  themselves  by  irre- 
gular pawing  movements  on  the  part  of  the  patient.  The 
animal  comes  out  from  the  stable  stiff,  even  dead-lame,  and 
the  limb  is  carried  with  the  lower  joints  semiflexed.  The 
breathing  is  hurried  and  the  pulse  firm  and  frequent,  while 
in  a  bad  case  patchy  perspiration  breaks  out  at  intervals 
on  various  parts  of  the  body.  If  with  this  we  get  a  puffy 
and  tender  swelling  in  the  hollow  of  the  heel,  our  diagnosis 
may  be  certain  at  any  rate  as  to  the  existence  of  joint 
trouble,  although,  from  reasons  we  have  given,  we  may  not 
be  able  to  mark  its  exact  nature. 

2.  Chronic. — Simple  synovitis  may  in  many  instances 
become  chronic.  In  this  case  we  have  simply  a  pouring 
into  the  synovial  capsule  of  serous  fluid,  and  with  it  an 
increased  quantity  of  synovia — this  time  with  an  absence 
of  the  usual  inflammatory  phenomena.  Beyond  the  swell- 
ing of  the  capsule  there  is  little  to  be  noticed.  The  joint 
becomes  perhaps  a  little  weaker,  but  pain  or  tenderness  and 
heat  are  entirely  absent.  Such  a  condition,  by  reason  of 
the  natural  rigidity  of  the  parts,  is  not  to  be  observed  in 
the  foot,  although  at  times  it  must  most  certainly  occur. 
Examples  of  such  a  condition  are  to  be  found  in  bog-spavin, 


416        DISEASES  OF  THE  HORSE'S  FOOT 

in  hygroma  of  the  stifle,  and  sometimes  in  the  fetlock. 
From  a  study  of  these,  we  know  that  they  may  be  induced 
by  frequent  attacks  of  acute  synovitis,  from  repeated  slight 
injuries  or  bruises,  or  from  strains  to  the  ligaments  of  the 
joint;  or  that  they  may  be  chronic  from  the  outset.  We 
know,  too,  that  in  such  cases  the  synovial  membrane  be- 
comes thickened,  and  that  in  places  it  may  have  extended 
somewhat  over  the  edges  of  the  articular  cartilages.  It  is 
only  fair  to  suppose  that  such  changes  occur  also  in  the 
pedal  articulation.  In  that  case  we  may  take  it  for  certain 
that  the  natural  rigidity  of  the  surrounding  structures 
has  the  effect  of  pushing  the  thickened  membrane  further 
between  the  bones  of  the  joint  than  occurs  in  a  like  condi- 
tion elsewhere,  leading,  of  course,  to  a  lameness  that  is 
marked  in  degree  but  occult  as  to  cause. 

In  our  minds  there  is  no  doubt  that  many  of  the  occult 
and  chronic  forms  of  foot-lameness  we  meet  with  in  prac- 
tice are  in  this  way  to  be  accounted  for.  We  may,  in  fact, 
explain  them  by  suggesting  either  a  chronic  synovitis  alone, 
or  a  synovitis  complicated  with  periostitis. 

Treatment  of  Synovitis. — If  a  joint  has  been  injured,  as 
we  have  suggested,  by  slight  blows  or  other  causes — in 
other  words,  if  the  injury  is  subcutaneous,  and  no  wound  is 
in  existence — then  there  is  no  treatment  which  offers  better 
results  than  does  the  continued  application  of  cold. 

At  the  same  time,  the  animal  should  be  slung,  or  if  non- 
excitable  and  inclined  to  rest,  allowed  at  intervals  to  lie  on 
a  thick  and  comfortable  straw  bed,  the  cold  fomentations 
during  such  intervals  being  discontinued.  When  the  case 
is  a  marked  one  and  the  animal  valuable,  benefit  will  be 
derived  from  the  application  of  crushed  ice. 

The  animal's  condition  must  be  watched,  and  the  case 
helped  as  far  as  is  possible  by  the  administration  of  a  mild 
dose  of  physic,  by  saline  drinks,  and,  when  necessary,  by 
the  giving  of  small  but  repeated  doses  of  Fleming's  tincture 
of  Aconite  in  order  to  relieve  the  pain.  In  a  chronic  case 
the  repeated  application  of  a  blister  is  indicated. 


DISEASES  OF  THE  JOINTS  417 

(h)  Purulent  or  Suppurative  Synovitis. 

In  this  condition  we  have  synovitis  complicated  by  the 
presence  of  pus.  Unlike  the  simple  form,  it  shows  a 
marked  disposition  to  spread,  and  quickly  involves  the  sur- 
rounding structures.  Very  soon  the  ligaments  of  the  joint, 
the  periosteum,  the  articular  cartilages,  and  the  bones  are 
implicated.  This,  of  course,  constitutes  a  condition  of 
acute  purulent  arthritis.  Under  that  heading,  therefore, 
the  condition  will  be  later  discussed. 


B.    AETHRITIS. 
(a)  Simple  or  Serous  Arthritis. 

With  an  attack  of  simple  synovitis  it  may  be  always  as- 
sumed that  the  changes  commenced  in  the  synovial  mem- 
brane, communicate  themselves  more  or  less  readily  to  the 
surrounding  tissues,  and  are  not  confined  to  the  synovial 
membrane  alone.  We  may  thus  have  the  inflammatory 
phenomena  asserting  themselves  in  the  surrounding  liga- 
ments, in  the  periosteum,  in  the  bone,  and  in  the  articular 
cartilages.  It  depends,  in  fact,  upon  the  severity  of  our 
case  whether  we  call  it  synovitis  or  arthritis.  The  two 
conditions  merge  so  the  one  into  the  other  that  no  hard- 
and-fast  rule  may  be  laid  down  whereby  they  may  with 
certainty  be  differentiated.  Such  symptoms,  therefore,  as 
we  have  given  for  synovitis  may  be  also  read  as  indicating 
a  condition  of  simple  arthritis.  The  course  of  the  case  will 
be  very  similar,  and  the  treatment  to  be  followed  identical 
with  that  just  given. 

(b)  Acute  Arthritis. 

Causes. — An  attack  of  acute  arthritis  may  commence  with 
the  affection  of  the  synovial  membrane,  and  spread  from 
that  to  the  other  structures.  In  other  cases  the  disease  of 
the  synovial  membrane,  and  after  it  the  disease  of  the  joint, 
may  be  secondary  to  diseases  commencing  in  the  structures 
around  the  joint.     This  affection  may  therefore  follow  on  a 


418         DISEASES  OF  THE  HORSE'S  FOOT 

case  of  acute  coronitis,  a  case  of  suppurating  corn,  a  case 
of  quittor,  a  severe  case  of  tread,  or  may  attend  a  case  of 
laminitis. 

Symptoms. — In  our  cases  we  get  very  little  beyond  a  mag- 
nification of  such  symptoms  as  we  have  described  under 
acute  synovitis.  The  heat  and  the  pain  is  perhaps  greater, 
and  the  lameness  more  marked.  It  is  rather  to  the  con- 
stitutional disturbance  we  must  look,  however,  for  a  con- 
firmation of  our  opinion  that  arthritis  is  in  existence.  This 
is  always  severe,  and  of  an  acute  febrile  nature.  The  pulse 
is  fast,  thin,  and  thready,  the  respirations  enormously  in- 
creased, and  the  temperature  high.  The  appetite  is  in 
abeyance,  the  animal  quickly  becomes  what  is  termed 
'  tucked-up,'  or  greyhound-like,  in  the  body,  and  patchy 
perspirations  break  out  about  him.  The  limb  is  held  with 
the  joints  all  semiflexed,  and  severe  and  intense  throbbing 
pains  are  indicated  by  the  frequent  pawing  movements  the 
animal  makes  in  the  air.  Manipulation  of  the  foot  is  re- 
sented, and  the  agonizing  intensity  of  the  pain  so  caused  is 
shown  by  the  drawn  and  haggard  appearance  of  the  eyes. 

In  a  favourable  case  the  symptoms  from  now  onwards 
may  gradually  subside.  The  appetite  returns,  the  breathing 
and  other  signs  of  disturbance  show  a  return  to  the  normal, 
weight  is  placed  on  the  limb,  and  resolution  slowly  but 
surely  takes  place.  In  many  of  these,  our  favourable  cases, 
however,  resolution  is  incomplete,  and  recovery  only  takes 
place  at  the  expense  of  anchylosis  of  the  joint,  a  condition 
we  shall  refer  to  later. 

In  unfavourable  cases,  and  these  unfortunately  are  only 
too  common,  the  condition  terminates  in  suppuration. 

(c)  Purulent  or  Suppurative  Arthritis. 

Definition. — By  this  term  we  indicate  an  arthritis  com- 
plicated by  the  formation  of  pus  within  the  joint. 

Causes. — The  organisms  of  pus  may  infect  the  joint  by 
extension  of  a  suppurating  process  from  without.  For 
example,  in  the  case  of  a  suppurating  corn,  in  quittor,  in 
tread,  or  in  the  case  of  a  suppurating  wound  caused  by 


DISEASES  OE  THE  JOINTS  419 

a  prick,  the  pus  formed  may  in  many  instances  be  very 
near  the  capsular  ligament  of  the  articulation.  Under 
such  circumstances,  unless  there  is  a  free  and  unhindered 
flow  of  the  pus  from  an  outside  opening,  inroads  will  be 
made  by  it  upon  the  thin  capsule.  The  latter  is  quickly 
penetrated,  and  pus  is  admitted  to  the  interior  of  the  joint. 

In  other  cases  infection  of  the  joint  may  proceed  from 
within,  from  a  poisoned  state  of  the  blood-stream.  The 
condition  occurs,  for  instance,  in  bad  attacks  of  laminitis. 
We  ourselves,  too,  have  seen  two  cases  where  suppuration 
of  the  pedal  articulation  occurred  in  the  septic  pyaemia  of 
foals,  a  disease  known  commonly  as  '  joint-ill,'  and  charac- 
terized by  an  infected  state  of  the  circulation.  Cases  have 
also  come  under  our  notice  where  this  condition  has  re- 
sulted from  slight  injuries  in  the  region  of  the  insertion  of 
the  extensor  pedis  inflicted  by  the  animal  himself  when 
galloping  away. 

Perhaps,  however,  the  most  common  cause  of  suppura- 
tive arthritis  in  the  foot  is  direct  penetration  of  the  arti- 
culation in  the  case  of  pricks.  The  penetrating  object  is 
nearly  always  dirty — bacterially  dirty,  at  any  rate — and 
suppuration  only  too  readily  commences.  Even  should  such 
a  wound  be  inrl.icted  by  an  aseptic  body,  infection  would 
quickly  ensue  as  a  result  of  the  wound  gathering  dirt  from 
the  ground,  or  even  from  admission  to  the  joint  of  impure 
and  bacilli-laden  air. 

Symptoms  and  Diagnosis. — This  is  one  of  the  most 
serious  conditions  we  are  called  upon  to  face  when  deal- 
ing with  diseases  of  the  foot,  for  in  many  cases  it  quickly 
ends  in  exhaustion  and  death  of  the  patient,  while  in  even 
the  most  favourable  cases  nothing  better  than  a  condition 
of  complete  and  bony  anchylosis  is  to  be  expected.  The 
owner,  therefore,  should  be  warned  accordingly. 

As  in  the  other  joint  affections,  so  here,  we  get  all  the 
symptoms  of  acute  febrile  constitutional  disturbance.  The 
pulse,  the  temperature,  the  respirations,  and  the  general 
haggard,  '  tucked-up.'  and  distressed  appearances  of  the 
animal  all  tell  too  plain  a  tale.     Our  patient  is  in  constant 


420        DISEASES  OF  THE  HORSE'S  FOOT 

pain,  and  the  seat  of  the  trouble  is  clearly  enough  shown 
by  the  constant  pawing  movements  of  the  affected  foot.  If 
he  has  room  to  get  up  and  down  in  comfort  the  animal 
adopts  for  long  periods  at  a  stretch  the  recumbent  position, 
and  is  not  upon  his  legs  long  enough  to  take  the  necessary 
amount  of  food  to  keep  him  going.  Even  when  down,  it  is 
plain  to  see  that  the  animal  is  not  at  rest.  The  pawing 
movement  is  still  maintained  with  the  foot,  and  every  now 
and  again  the  eyes  are  opened  and  the  head  is  lifted  to 
give  a  troubled  look  around.  The  appetite,  too,  is 
capricious,  and  in  many  cases  almost  entirely  lost. 

In  some  slight  degree  the  condition  is  less  to  be  feared 
in  a  fore  than  in  a  hind  foot — that  is,  so  far  as  absolutely 
fatal  results  are  concerned.  With  the  condition  confined 
to  one  fore-foot,  the  animal  is  able  to  get  up  and  down  with 
a  moderate  degree  of  comfort.  At  intervals,  therefore,  he 
rises  to  take  nourishment,  and  as  soon  as  his  wants  are 
satisfied  again  lies  down. 

With  the  disease  in  a  hind-foot  matters  are  not  taken 
so  comfortably.  The  patient  finds  that  with  each  day's 
increasing  weakness  the  difficulty  that  at  first  he  had  to 
raise  himself  with  only  one  sound  hind-foot  becomes 
enrmously  increased.  The  consequence  is  that  he  fears 
to  go  down,  and  the  standing  position  is  maintained  until 
sheer  weakness  overcomes  him,  and  he  goes  down,  not  to 
rise  again  without  assistance. 

If  judiciously  attended  he  is,  of  course,  put  in  slings 
before  this  stage  is  reached ;  but  there  are  instances,  as 
in  the  case  of  a  cart-mare  heavy  with  foal,  where  the  use 
of  slings  is  most  decidedly  contra-indicated. 

If  doubt  before  existed  as  to  the  nature  of  the  case,  it  is 
at  a  later  stage  dispelled  by  the  appearance,  generally  in 
the  hollow  of  the  heel,  of  a  hot  and  painful  swelling.  This 
at  first  is  hard,  but  later  fluctuates.  Finally  it  breaks  at 
one  or  more  spots,  and  there  exudes  from  the  opening 
or  openings  a  purulent  and  oftentimes  sanious  discharge, 
which  coagulates  about  each  fistula  after  the  manner  of 
ordinarv  svnovia. 


DISEASES  OF  THE  JOINTS  421 

With  the  discharge  of  the  abscess  contents  there  is  some 
slight  improvement  in  the  symptoms.  Here,  with  a  suitable 
treatment,  and  with  a  patient  of  a  particularly  robust  con- 
stitution, the  case  appears  to  turn,  and  slowly  but  surely 
progresses  towards  the  only  end  we  can  hope  for — namely, 
a  more  or  less  painless  anchylosis  of  the  articulation. 

In  less  favourable  cases  the  purulent  discharge  continues, 
and  (  always  a  bad  sign  )  becomes  more  or  less  chocolate- 
like in  colour,  distinctly  thin,  and  stinking.  The  diseased 
process  spreads  until  the  ligaments  of  the  joint,  both  by 
reason  of  their  infiltration  with  the  inflammatory  discharges, 
and  also  on  account  of  the  ravages  made  on  them  by  the 
invading  pus,  either  greatly  stretch  or  altogether  rupture. 

The  joint,  after  its  ligaments  have  been  destroyed  in  this 
manner,  is  loosened,  and  the  bones  are  now  freely  movable. 
Their  manipulation  gives  to  the  touch  a  sickening,  grating 
sound — in  other  words,  we  have  crepitus.  This,  of  course, 
indicates  that  the  articular  cartilages  have  become  greatly 
eroded  by  the  inflammatory  process,  and  so  left  what  we 
may  term  '  raw  '  surfaces  of  bone  to  rub  together.  When 
the  animal  is  put  to  the  walk  the  toe  of  the  foot  is  elevated, 
and  the  extreme  mobility  of  the  foot  gives  one  the  idea  of 
fracture.  With  every  step  there  is  a  peculiar  sucking 
noise,  comparable  to  that  of  a  foot  moving  in  a  boot  of 
water,  and  putrescent  matter  is  squeezed  from  every  open- 
ing each  time  the  foot  is  put  to  the  ground.  Although  we 
have  seen  cases  even  advanced  thus  far  recover,  it  is  ques- 
tionable whether  it  is  now  wise  to  attempt  to  prolong  life. 
Slaughter  is  far  more  humane,  and,  in  our  opinion,  except 
with  a  valuable  brood  animal,  more  economical. 

If  the  animal  is  allowed  to  linger,  other  symptoms  will 
nearly  always  present  themselves  before  death  occurs. 
Whether  in  slings  or  not,  a  careful  watch  should  be  kept 
upon  the  sound  limb.  For  some  time  the  patient  stands 
upon  it  incessantly,  but  sooner  or  later  it  happens  that  a 
further  visit  show  us  the  animal  standing  with  full  weight 
on  the  diseased  foot,  and  making  painful  pawing  movements 
with  what  before  was  the  sound.    We  immediately  jump  to 


422         DISEASES  OF  THE  HORSE'S  FOOT 

the  conclusion  '  laminitis.'  And  so  it  is,  but  it  is  a  laminitis 
brought  about  by  pyaemia.  This  is  indicated  by  the  swollen 
and  oedematous  nature  of  the  lymphatics  of  the  limb.  Plainly 
enough  they  indicate  the  road  by  which  the  poison  has 
travelled.  It  is  in  this  way :  Pus  and  putrefactive  organisms 
have  gained  entrance  to  the  lymphatics  of  the  original 
diseased  limb.  From  these  they  have  rapidly  gained  the 
blood-stream  and  set  up  infection  elsewhere.  In  this  par- 
ticular instance  it  is  demonstrated  by  the  laminitis  and 
lymphangitis  of  the  previously  sound  limb.  With  the 
poison  thus  circulating  in  the  blood-stream,  we  often  also 
get  spots  of  infection  commenced  in  one  or  other  of  the 
more  vital  organs — notably  the  lungs  or  the  kidneys.  The 
end  of  our  case  is  then  either  a  gangrenous  pneumonia  or 
complications  induced  by  a  condition  of  widespread  pyaemia. 

With  the  animal  in  slings  there  are  one  or  two  other 
symptoms  that  call  for  attention.  In  many  cases,  especially 
with  animals  of  a  lymphatic  and  indolent  nature,  the  use 
made  of  them  is  inordinate.  The  patient  rests  so  continually 
in  them  that  alarming  swellings  commence  to  make  their 
appearance  about  the  rectum,  or  in  the  case  of  a  mare 
about  the  vulva.  The  animal  must  then  be  let  down  at 
regular  intervals  and  again  raised  when  rest  is  obtained. 

A  more  alarming  symptom  still  is  when  the  animal,  in- 
stead of  resting  in  the  slings  by  his  buttocks,  casts  his 
weight  bodily  into  the  belly-rest  and  hangs  writh  a  heavy 
head  into  the  head-stall.  This  indicates  complete  exhaus- 
tion and  a  wish  for  death.  Matters  should  therefore  be 
explained  to  the  owner,  and  his  consent  obtained  for  imme- 
diate destruction. 

Pathology. — The  pathological  changes  occurring  in  sup- 
purative arthritis  we  shall  pass  over  briefly.  It  is  almost 
sufficient,  in  fact,  to  say  that  the  whole  of  the  joint  becomes 
completely  disorganized. 

The  synovial  membrane  becomes  so  tremendously  thick- 
ened and  injected  as  to  be  scarcely  recognisable  as  such, 
the  thickening  in  the  later  stages  being  due  to  large  growths 


DISEASES  OF  THE  JOINTS  423 

of  granulation  tissue  which  entirely  alter  the  appearance  of 
the  membrane  as  we  know  it  normally. 

In  the  early  stages  the  contents  of  the  joint  are  composed 
of  thin  pus  and  synovia.  Later,  as  destruction  of  the 
synovial  membrane  proceeds,  the  Mow  of  synovia  is  stopped, 
while  the  pus  formation  goes  on  until  finally  nothing  but 
pus  and  dead  tissue  products  fill  the  cavity. 

If  the  suppurative  process  has  commenced  from  within, 
the  pus  that  is  formed  is,  as  a  rule,  thick  and  creamy,  com- 
paratively unstained,  and  free  from  marked  odour.  If, 
on  the  other  hand,  air  has  gained  access  to  the  joint,  or  the 
suppurative  process  has  started  from  the  materials  intro- 
duced by  a  foreign  body,  the  joint  contents  are  thin,  blood- 
stained, and  stinking. 

The  inflammatory  changes  in  the  joint  soon  spread  to  the 
ligaments,  and  to  the  soft  structures  in  contact  with  them. 
This  means  that  the  ligaments  become  infiltrated  with  in- 
flammatory exudate,  that  the  fibrous  bundles  composing 
them  become  separated,  and  that  the  ligaments  are  weakened 
and  easily  stretched.  As  a  consequence,  a  certain  amount 
of  displacement  or  dislocation  of  the  bones  is  allowed. 

In  like  manner  the  inflammatory  changes  keep  spreading 
until  we  have  the  periosteum  next  the  ends  of  the  bones 
affected.  The  periostitis  thus  set  up  invariably  takes  the 
osteoplastic  form,  and  as  a  result  of  this  we  have  growths 
of  new  bone  in  the  near  neighborhood  of  the  joint.  It  is  in 
the  later  stages  of  the  disease — that  is,  when  the  pus  has 
been  evacuated  and  reparative  changes  commenced — that 
this  osteoplastic  periostitis  is  most  marked,  and  it  plays 
a  large  part  in  bringing  about  the  condition  of  anchylosis, 
which  we  shall  afterwards  describe. 

Grave  changes  also  occur  in  the  articular  cartilages. 
They  quickly  lose  their  peculiar  glistening  polish,  their 
semitransparency  is  lost,  and  the  natural  tint  of  a  pearl-like 
blue  gives  way  to  a  dirty  yellow.  Later  this  is  followed  by 
erosion  of  the  cartilages  at  such  points  as  they  happen  to 
be  in  greatest  contact.  The  ends  of  the  bones  are  thus 
exposed,  and  their  medullary  cavities  exposed  to  infection. 


424        DISEASES  OF  THE  HORSE'S  FOOT    ■ 

As  a  result  we  get  in  them  the  changes  we  have  already 
described  under  Ostitis. 

Treatment — (a)  Preventive. — Seeing  that  many  of  these 
cases  have  their  starting-point  in  stabs  or  penetrating 
wounds  of  the  sole,  we  shall  be  concerned  first  with  a  con- 
sideration of  the  correct  treatment  to  be  adopted  when  we 
know  the  wound  to  have  reached  the  articulation. 

Only  too  frequently  the  treatment  practised  is  that  of 
poulticing.  In  other  portions  of  this  work  we  have  pointed 
cut  the  advantages  that  a  continued  antiseptic  bathing  has 
over  the  application  of  a  poultice,  the  greater  readiness  with 
which  the  solution  comes  into  contact  with  the  deeper  parts 
of  the  wound,  and  the  far  greater  chance  there  is  of  main- 
taining water  in  an  antiseptic  condition  than  there  is  of 
keeping  a  poultice  in  the  same  state.  There  is  no  doubt, 
that  in  this  case  also,  the  cold  or  warm  antiseptic  bath  is  to 
be  preferred  to  the  poultice.  It  is  questionable,  however, 
whether  even  the  bath  is  sufficient  for  our  purpose  here. 
We  have  in  this  case  a  deep  punctured  wound,  and  a  wound 
that  in  every  probability  is  infected  with  the  organisms  of 
pus  or  of  putrefaction.  It  is  a  wound,  moreover,  which  is 
likely  to  impede  the  thorough  access  to  it  of  the  solution 
in  which  the  foot  is  fomented,  on  account  of  the  flakes  of 
coagulated  fibrin  which  fill  it. 

The  most  rational  treatment,  therefore,  if  we  get  to  the 
case  early  enough,  is  to  irrigate  the  wound  freely  with  a 
solution  of  carbolic  acid  in  water  (1  in  20),  or  with  a  solu- 
tion of  perchloride  of  mercury  (1  in  1,000),  injected  by 
means  of  a  glass  syringe,  or  the  pattern  of  syringe  devised 
for  quittor.  This  injecting  should  be  done  thoroughly,  and 
by  that  we  mean  that  several  syringefuls  of  the  solution 
should  be  injected,  the  joint  after  each  injection  being 
manipulated  so  as  to  distribute  the  solution  as  far  as  pos- 
sible over  it.  When  this  is  done  the  opening  in  the  sole  may 
be  plugged  with  a  little  perchloride  of  mercury,  or  better 
still,  with  a  little  piece  of  tow  saturated  with  a  concentrated 
solution  of  perchloride  of  mercury  or  a  solution  of  iodoform 
in  alcohol,  and  an  antiseptic  pad  of  tow  or  lint  placed  over 


DISEASES  OF  THE  JOINTS  425 

all.  The  foot  should  then  be  bandaged  and  encased  in  a 
boot  or  sacking  protective.  The  bandage  should  be  removed 
daily  and  the  antiseptic  pad  changed.  At  each  visit  the 
animal's  condition  must  be  carefully  noted.  So  long  as 
constitutional  disturbance  is  slight,  the  foot  appears  com- 
fortable, is  free  from  marked  heat  and  tenderness,  and  paw- 
ing movements  are  absent,  and  so  long  as  the  discharge  on 
the  pad  appears  non-purulent,  free  from  marked  odour,  and 
small  in  quantity,  then  this  dressing  may  be  persisted  in. 

This  treatment  of  open  joint,  preventive  as  it  is  of 
arthritis,  is  also  indicated  in  the  case  of  open  navicular 
bursa.  In  several  instances  we  have  practised  this  treat- 
ment for  the  dressing  of  wounds  implicating  the  bursas  of 
tendons  and  the  capsules  of  joints.  It  is  also  spoken  of 
favourably  by  Air.  C.  H.  Flynn  in  the  American  Veterinary 
Review  for  June,  1888,  whose  treatment  is  as  follows: 
'  Place  the  patient  in  a  clean,  well-ventilated,  and  drained 
stable.  Have  all  the  littler  removed,  and  insist  on  the  stall 
being  kept  clean.  Either  place  the  animal  in  slings,  or  tie 
the  head  so  as  to  prevent  lying  down.  Clip  the  hair  and 
cleanse  the  parts  well.  He  prefers  the  corrosive  sublimate 
solution  (1  in  1,000).  Should  the  wound  be  of  two  or 
more  days'  standing,  inject  the  joint  with  the  corrosive  sub- 
limate solution.  Xow  dry  the  parts  with  a  clean  towel  and 
sprinkle  the  wound  with  iodoform.  Over  this  place  a  thick 
layer  of  absorbent  cotton-wool,  filled  with  iodoform,  band- 
age securely,  and  keep  the  patient  on  a  moderate  diet,  pre- 
serving the  utmost  quietude  possible.  Should  the  bandage 
remain  in  position  and  the  animal  free  from  pain,  leave  the 
bandage  and  dressing  in  place  from  five  days  to  a  week. 
Then  change  it,  and  should  the  discharge  be  little,  do  not 
disturb  it,  but  renew  the  iodoform  and  cotton  dressing,  leav- 
ing it  on  for  another  week.' 

Other  treatments  for  the  same  condition  are  practised,  in 
which  the  wound  is  dusted  with  powdered  iodoform,  with 
potassium  permanganate,  or  with  corrosive  sublimate,  or 
where  the  wound,  instead  of  being  dusted,  has  the  corrosive 
sublimate  applied  in  the  form  of  a  plug.     In  each  case  the 


426        DISEASES  OF  THE  HORSE'S  FOOT 

preliminary  irrigation  with  the  corrosive  sublimate  solution 
is  dispensed  with.  This,  however,  should  on  no  account  be 
omitted.  In  our  opinion  it  constitutes  the  very  essence  of 
the  rationality  of  the  treatment. 

\(b)  Curative. — It  may  happen,  however,  and  often  does, 
that  this  first  injection  of  an  antiseptic  is  unsuccessful  in 
preventing  organismal  infection  of  the  wound.  In  this 
case  grave  constitutional  disturbance  and  other  untoward 
symptoms  such  as  we  have  already  described  quickly  make 
their  appearance. 

The  animal  should  now  be  placed  in  slings  and  prepara- 
tions made  for  actively  treating  the  wound  with  antiseptics. 
Whether  we  fail  or  not,  we  have  the  satisfaction  of  knowing 
that  we  have  given  to  the  patient  the  best  and  the  only 
chance  of  recovery. 

It  should  be  remembered,  however,  and  should  be  pointed 
out  to  the  owner,  that  with  purulent  arthritis  fully  devel- 
oped, with  the  grave  constitutional  changes  it  occasions, 
and  with  the  ever-present  danger  of  a  general  septic  in- 
vasion of  the  blood-stream,  that  the  human  surgeon  under 
such  circumstances  offers  to  his  patient  the  alternatives  of 
amputation  or  probable  death.  With  us  no  such  alterna- 
tive is  possible.  It  is  either  return  the  joint  to  some  sem- 
blance of  its  former  usefulness,  or  destroy  the  patient. 

In  this  case  we  advise  the  injection  of  the  original  wound, 
and  also  such  fistulous  openings  as  may  have  formed,  with 
the  1  in  1,000  sublimate  solution.  Also,  in  order  to  avoid 
ihe  sometimes  abortive  attempts  of  the  antiseptic  pad,  to 
maintain  a  condition  of  asepsis  around  the  wound,  we 
advise  the  continual  soaking  of  the  whole  foot  in  a  cold 
antiseptic  bath.  This  may  be  either  carbolic  acid  1  in  20, 
or — what  is  less  volatile,  perhaps  more  effectual,  and  cer- 
tainly more  economical — perchloride  of  mercury  1  in  1,000. 

It  has  been  our  good  fortune,  even  when  we  have  seen 
the  foot  almost  detached  from  the  limb  by  the  devastating 
inroads  of  the  pus,  to  see  the  suppurative  process  by  this 
means  gradually  overcome,  a  reparative  anchylosis  set  in, 


DISEASES  OF  THE  JOINTS  427 

and  the  animal  restored  to  good  health  and  usefulness,  if 
not  to  soundness. 

Once  the  suppurative  process  is  checked  and  anchylosis 
commences,  it  is  good  treatment  to  smartly  blister  the  whole 
of  the  region  of  the  coronet,  the  pastern,  and  the  wound 
itself  with  a  mixed  blister  of  cantharides  and  biniodide  of 
mercury,  repeated  at  intervals  of  a  fortnight.  This  prevents 
to  some  extent  further  infection  of  the  wound,  and  assists 
also  in  promoting  the  changes  that  tend  to  anchylosis. 

(d)  Anchylosis. 

The  word  anchylosis  signifies  the  stiffening  of  a  joint. 
When  one  has  read  the  serious  changes  occurring  within 
the  joint  in  the  more  serious  forms  of  arthritis,  it  is  easy  to 
understand  how  it  comes  about.  In  suppurative  arthritis, 
for  instance,  we  have  the  synovial  membrane  destroyed,  the 
articular  cartilages  partly  or  wholly  obliterated,  and  the 
former  boundaries  of  the  joint  entirely  lost.  If  the  animal 
lives,  nature  is  found  to  make  repair  of  a  sort.  The  synovial 
membrane  and  the  articular  cartilages  utterly  destroyed,  as 
we  have  described,  cannot  again  be  replaced.  Nature  can 
only  build  again  from  such  materials  as  are  left  to  her.  In 
this  case  the  material  is  bone. 

It  must  be  remembered,  however,  that  often  the  bone 
has  been  so  diseased  that  spots  of  necrosis  or  caries  within 
it  are  bound  to  remain  unless  moved  by  operative  inter- 
ference. Such  diseased  portions,  when  dealing  with  the 
foot,  are  beyond  reach  of  the  surgeon's  knife,  and  we  have 
no  alternative  but  to  allow  them  to  remain.  We  get,  there- 
.  fore,  in  many  cases,  a  condition  of  raref active  ostitis  occur- 
ring side  by  side  with  a  slowly  progressive  caries  within 
the  bone,  while  outside  is  occurring  an  osteoplastic 
periostitis.  The  concurrence  of  these  conditions  leads  in 
time  to  great  increase  in  size  of  the  parts,  together  with  in- 
creasing anchylosis  and  deformity. 

C.    NAVICULAR  DISEASE. 
Definition. — Chronic  inflammatory  changes  occurring  in 
connection   with    the   navicular    bursa,    affecting   variously 


428         DISEASES  OF  THE  HORSE'S  FOOT 

the  bursa  itself,  the  perforans  tendon,  or  the  navicular 
bone,  and  characterized  by  changes  in  the  form  of  the  hoof 
and  persisting  lameness,  The  disease  is  commonly  noticed 
in  thoroughbreds  or  in  horses  of  the  lighter  breeds,  and  is 
but  seldom  observed  in  heavy  cart  animals.  Usually  it  is 
met  with  in  one  or  both  fore-feet.  Although  of  extremely 
rare  occurrence,  it  has  been  noticed  in  the  hind. 

History. — To  English  veterinarians  appears  to  belong  the 
credit  of  discovering  navicular  disease.  As  early  as  1752 
we  find  one,  Jeremiah  Bridges,  in  {  No  Foot,  No  Horse,' 
drawing  attention  to  '  coffin-joint  lameness,'  and  advocating 
for  its  treatment  setoning  of  the  frog.  It  appears,  too, 
that  Moorcroft,  prior  to  his  departure  for  India  in  1808, 
was  acquainted  with  what  was  then  known  as  cofnn-joint* 
lameness,  having  drawn  attention  to  it  in  1804  in  a  letter 
to  Sir  Edward  Codrington.+  In  1819  Moorcroft  made 
it  even  plainer  still  that  he  was  fully  acquainted  with  what 
we  now  know  as  navicular  disease.  This  we  learn  from 
a  letter  written  by  him  to  Sewell,  in  which  he  laid  claim 
to  being  the  originator  of  neurectomy.  In  this  letter  he 
says : 

'  On  dissecting  feet  affected  wtih  these  lamenesses,  the 
flexor  tendon  was  now  and  then  observed  to  have  been 
broken,  partially  or  entirely,  but  more  commonly  to  have 
been  bruised  and  inflamed  in  its  course  under  the  navicular 
or  shuttle  bone,  or  at  its  insertion  into  the  bone  of  the  foot. 
Sometimes,  although  seldom,  the  navicular  bone  itself  has 
been  found  to  have  been  fractured ;  at  others  its  surface 
has  been  deprived  of  its  usual  coating,  and  studded  with 
projecting  joints  or  ridges  of  new  growth,  or  exhibiting 
superficial  excavations  more  or  less  extensive. 't 

Pathology  and  Point  of  Commencement  of  the  Disease. — 

The  exact  position  in  which  the  diseased  process  starts  has 

for  a  long  time  been  a  subject  of  discussion,  and  even  now 

it  is  doubtful  whether  the  joint  has  been  definitely  settled. 

To  mention  but  a  few  among  many :     We  find  Mr.  Broad, 

of  Bath,  strenuously  insisting  on  the  fact  that  the  disease 

*  The  coffin- joint  at  this  time  included  the  navicular  bursa. 
t  Percival's   '  Hippopathology,'  vol.  iv.,  p.   132.  X  Ibid. 


DISEASES  OF  THE  JOINTS  429 

commences  in  the  interior  of  the  navicular  bone.  Just  as 
strenuously  we  find  the  editor  of  the  journal  in  which  the 
matter  is  being  discussed,  the  late  Mr.  Fleming,  asserting 
that  the  disease  commences  in  the  bursa. *  Others,  too, 
hold  that  the  disease  commences  primarily  in  the  tendon. 
Wedded  to  this  view  was  the  discoverer,  Mr.  Turner,  of 
Croydon;  while  Percival  commits  himself  to  the  statement 
that  it  is  either  the  central  ridge  or  the  postero-  inferior 
surface  of  the  navicular  bone,  or  the  opposed  concavity  in 
the  perforans  tendon,  that  shows  the  earliest  signs  of  the 
disease.  The  observations  made  by  Dr.  Brauell,  the  first 
Continental  writer  to  fully  describe  the  disease,  led  him  to 
the  statement  that  neither  the  bone  nor  the  bursa  was  the 
invariable  starting-point  of  the  trouble,  but  that  usually  it 
commenced  in  inflammation  of  the  bursa  itself. 

Without,  therefore,  committing  ourselves  to  an  expres- 
sion of  opinion  as  to  the  precise  starting-point  of  the  affec- 
tion, we  shall  describe  the  pathological  changes  occurring  in 
navicular  disease  as  noted  in  (1)  the  bursa,  (2)  the  carti- 
lage, (3)  the  tendon,  and  (4)  the  bone. 

1.  Changes  in  the  Bursa. — Upon  the  internal  surface  of 
the  bursal  membrane  is  first  noticed  a  slight  inflammatory 
hyperemia,  accompanied  by  more  or  less  swelling  and  tume- 
faction, owing  to  its  infiltration  with  inflammatory  exudate. 
The  portion  covering  the  hyaline  cartilage  of  the  navicular 
bone  has  lost  its  peculiar  pearl-blue  shimmer,  and  become  a 
dirty  yellow. 

Remembering  that  the  bursal  membrane  is  a  synovia- 
secreting  one,  and  bearing  in  mind  what  happens  in 
ordinary  synovitis  and  arthritis  (with  which,  of  course, 
this  may  be  very  closely  compared),  we  shall  first  expect 
changes  in  the  bursal  contents.  It  is  highly  probable, 
though  difficult  of  proof,  that  in  the  very  early  stages  the 
chronic  inflammatory  stimulus  has  the  effect  of  increasing 
the  flow  of  synovia.  In  every  case,  however,  where  it  can 
with  any  certainty  be  said  that  navicular  disease  exists,  it 
•is  too  late  to  meet  with  this  condition.     The  disease  has 

*   Percival's   '  Hippopathology,'  vol.   iv.,  p.   i32. 


430        DISEASES  OF  THE  HORSE'S  FOOT 

then  progressed  until  destruction  of  the  secreting  layer  of 
the  bursal  membrane  has  been  seriously  interfered  with, 
and  in  this  case  we  find  a  distinct  deficiency  in  the  quantity 
of  synovia  in  the  bursa.  In  advanced  cases  it  is  even 
found  that  the  bursa  is  absolutely  dry. 

2.  Changes  in  the  Cartilage. — Directly  that  portion  of  the 
bursal  membrane  covering  the  cartilage  is  the  subject  of 
inflammatory  change,  the  cartilage  itself,  by  reason  of  its 
low  vitality,  soon  suffers. 

Under  a  process,  which  we  may  term  '  dry  ulcerative,' 
the  cartilage  covering  the  ridge  on  the  lower  surface  of  the 
bone  commences  to  become  eroded,  and  in  appearance  has 
been  likened,  both  by  English  and  Continental  writers,  to  a 
piece  of  wood  that  has  been  worm-eaten  (see  Fig.  161). 


Fig.  161. — Navicular  Bone  (Postero-inferior  Surface)  showing 
the  'Worm-eaten'  appearance  caused  by  Erosion  of  the 
Hyaline   Cartilage,  and  commencing  Rarefactive  Arthritis. 

'  At  this  stage,  or  much  earlier  ' — we  are  quoting  Colonel 
Smith,  A.V.D.— *  may  be  found  calcareous  deposits  in  the 
fibro-cartilage  and  the  bone.  They  are  scattered  like  fine 
sand  here  and  there,  generally  across  the  inferior  half  of 
the  face  of  the  bone;  they. are  sometimes  numerous,  fre- 
quently scanty,  occasionally  entirely  absent.  The  amount 
of  calcareous  degeneration  depends  upon  the  lesions  pres- 
ent. If  much  destruction  of  bone  exists,  there  will  be  but 
few  calcareous  deposits ;  whilst  if  there  are  many  calcareous 
deposits,  there  may  be  but  slight  ulceration  of  bone  tissue, 
and  perhaps  none  at  all.  In  fact,  I  have  held  the  opinion, 
and  see  no  reason  to  modify  it,  that  calcareous  deposits  are 
safeguards  against  caries.'* 

*  Journal  of  Comparative  Pathology  and  Therapeutics,  vol.  vi., 
p.  195- 


DISEASES  OF  THE  JOINTS  431 

3.  Changes  in  the  Tendon. — The  effect  of  these  calcareous 
deposits  on  the  under  surface  of  the  bone  is  to  produce  a 
certain  amount  of  roughness.  Seeing  that  with  every 
movement  of  the  foot  the  perforans  tendon  is  called  upon 
to  glide  over  this  surface,  it  is  clear  that  a  secondary  effect 
must  be  that  of  inducing  erosion  and  destruction  of  the 
tendon.  The  point  at  which  this  usually  commences  is 
at  the  bottom  of  the  depression  that  accommodates  the 
ridge  on  the  bone.  With  erosion  of  the  cartilage  and  of 
the  tendon  at  points  exactly  opposite  each  other,  we  have 
two  surfaces  come  together  that  are  prone  to  readily  unite, 
and  fibrous  tissue  adhesions  often  take  place  between  the 
bone  and  the  tendon.  In  some  measure  this  accounts  for 
the  torn  and  ragged  appearance  of  the  tendon.  Adhesions 
take  place,  and,  under  some  small  strain,  are  broken  down. 
This  may  happen  more  than  once  or  twice,  and  with  each 
breaking  of  the  adhesion  between  the  bone  and  tendon, 
fibres  from  the  latter  are  lacerated  and  torn  from  their 
place  (see  Fig.  162). 

4.  Changes  in  the  Bone. — The  changes  occurring  in  the 
bone  are  essentially  those  of  a  rarefactive  ostitis.  These 
changes  are  described  by  many  writers,  and,  whether 
originating  primarily  in  the  bone  or  not,  it  seems  certain 
that  extensive  changes  may  have  occurred  within  the  bone, 
with  but  little  or  nothing  to  be  noted  on  its  outer  surface. 
It  would  seem  that  the  first  change  is  one  of  congestion  of 
the  vessels  of  the  bone's  cancellous  tissue.  With  the  cause, 
whatever  it  may  be,  in  constant  operation,  the  congestion 
persists  until  low  type  of  inflammation  is  set  up,  inter- 
fering, not  only  with  the  flow  of  synovia  in  the  adjoining 
bursa,  but  with  the  nutrition  of  the  bone  itself.  As  the 
disease  progresses,  there  is  softening  and  enlarging  of  the 
cancellated  tissue  towards  the  centre  of  the  bone.  The 
cells  break  up,  and  absorption  takes  place.  This  goes  on 
until  a  large  portion  of  the  interior  of  the  bone  is  in  a  state 
of  dry  necrosis,  with,  in  many  cases,  but  slight  signs  of 
mischief  on  the  exterior  of  the  bone. 

In  other  cases,  however,  the  changes  in  the  interior  of 


432 


DISEASES  OF  THE  HORSE'S  FOOT 


the  bone  are  accompanied  by  well-marked  lesions  on  its 
gliding  or  postero-inferior  surface,  and  by  evidences  of  an 
osteoplastic  periostitis  along  its  edges. 

That  an  osteoplastic  periostitis  has  been  in  existence  is 


Fig. 


162. — A   Foot   with  the   Seat   of   Navicular   Disease 
Exposed. 


On  the  anterior  surface  of  the  performans  fibres  of  the  tendon  are 
seen  to  be  torn  away  from  their  abnormal  adhesion  with  the 
navicular  bone,  while  others  are  seen  to  be  still  attached  there- 
to. The  surface  of  the  navicular  bone  itself  exhibits  small  de- 
fects in  the  bony  substance,  which  have  been  brought  about  by 
a  rarefactive  ostitis. 

a,  The  performans  tendon  cut  through  and  reflected ;  b,  the  sole. 

witnessed  by  the  appearance  along  the  edges  of  the  bone  of 
numerous    outgrowths    of    bone,    termed    osteophytes    (see 
Fig.  163). 
The   interosseous   and   postero-lateral   ligaments    of   the 


DISEASES  OF  THE  JOINTS 


433 


articulation  often  participate  in  the  inflammatory  changes, 
and  in  many  cases  become  completely  ossified.  The  true 
articulatory  surface  of  the  bone,  that  articulating  with  the 
os  pedis  and  with  the  os  coronae,  is  never  affected. 

Causes. — In  enumerating  the  causes  of  navicular  disease, 
we  shall  follow  the  example  of  Colonel  Smith  and  classify 
them  under  certain  headings — namely,  (  1  )  Hereditary  Pre- 
disposition ;  (2)  Compression;  (3)  Concussion;  (4)  A 
Weak  Navicular  Bone;  (5)  A  Defective  or  Irregular 
Blood-supply  to  the  Bone;  and  (6)  Senile  Decay. 


Fig.   163. — The   Navicular  Bone  from  a  Case  of  Long-standing 
Navicular  Disease. 

The  erosion  of  the  cartilage  on  its  central  ridge  is  most  marked, 
and  the  porous  appearance  of  the  bone  thus  uncovered  points 
to  the  existence  within  it  of  a  rarefactive  ostitis.  Along  its 
edges  large  osteophyte  outgrowths  speak  of  the  effects  of  an 
osteoplastic  periostitis.  ! 

1.  Hereditary  Predisposition, — That  navicular  disease  is 
hereditary  is  a  fact  that  has  for  a  long  time  been  insisted 
on,  and  has  come  to  be  so  generally  admitted  that  we  do 
not  intend  to  dwell  on  it  here.  As  we  have  said  before,  it 
is  found  in  the  lighter  breeds  of  horses  (and,  according  to 
Zundel,  especially  in  the  English  breeds  ),  and  is  there  seen 
to  be  frequently  transmitted  from  parent  to  offspring. 

2.  Compression. — By  this  is  meant  the  compression  of 
the  navicular  bone  between  the  os  pedis  and  the  os  coronae 
in  front,  and  the  perforans  tendon  behind. 

In  order  to  appreciate  this  explanation  of  the  causation 
of  navicular  disease  at  its  true  value,  it  will  be  well  to  con- 
sider briefly  the  physiology  of  the  parts  in  question. 


434        DISEASES  OF  THE  HORSE'S  FOOT 

The  navicular  bone  is  what  we  may  term  a  complement 
of  the  os  pedis.  It  exists,  in  fact,  simply  in  order  that  the 
os  coronse  may  have  a  sufficiently  large  articulatory  surface 
to  play  upon.  One  wonders  at  first  that  Nature  did  not 
arrive  at  this  by  originally  placing  a  larger  bone  below. 
Colonel  Smith  explains  this  by  suggesting  that  this  would 
in  all  probability  have  meant  its  fracture.  In  progression 
the.  hind  part  of  the  foot  comes  to  the  ground  first,  and 
upon  the  hinder  portion  of  the  articulation  would  fall  the, 
first  effects  of  concussion,  together  with  the  greater  part  of 
the  body-weight.  A  yielding  joint  was  in  this  position 
necessary,  and  that  formed  by  the  navicular  bone  fills  all 
requirements. 

In  this  connection  one  next  considers  the  part  played  by 
the  front  limbs  during  progression.  As  Zundel  expresses 
it,  they  are  columns  of  support  rather  than  of  impulsion, 
and,  as  the  body-weight  is  thrown  forward  by  the  hind- 
limbs,  it  is  the  duty  of  the  forelimbs  to  receive  it.  The 
shock  or  concussion  of  the  body-weight  thus  thrown  for- 
wards is  first  received  by  the  muscles  uniting  the  limb  to 
the  trunk,  and  a  great  part  of  it  there  minimized  by  their 
sling-like  attachment.  It  is  further  absorbed  by  the 
shoulder- joint,  and  from  there  passed  on  to  the  almost 
vertical  bony  column  represented  by  the  radius  and  ulna, 
the  knee,  and  the  metacarpus.  On  reaching  the  first 
phalanx,  a  portion  of  the  remaining  force  is  passed  on  to 
the  front  of  the  phalanges  and  loses  itself  in  front  of  the 
hoof,  while  the  other  portion  is  transmitted  to  the  flexor 
tendons,  finally  to  the  perforans,  and  to  the  posterior  parts 
of  the  foot.  During  progression,  therefore,  the  navicular 
bone  is  constantly  pushed  downwards  and  backwards  by 
the  bony  column,  and  is  just  as  constantly  pushed  forwards 
and  upwards  by  the  resistance  of  the  perforans  tendon. 
This  means,  of  course,  that  the  navicular  bone  is  more 
or  less  constantly  subject  to  compression,  and  constant 
pressure,  as  we  know  full  well,  is  a  pretty  sure  factor  in 
bringing  about  malnutrition  of  the  parts,  with  atrophy  or 
chronic  inflammatory  changes  as  an  end  result. 


DISEASES  OF  THE  JOINTS  435 

•  Even  with  the  limb  at  rest  the  pressure  on  both  sides  of 
the  navicular  bone  is  still  constant.  The  only  circum- 
stances under  which  we  can  conceive  of  it  being  entirely 
absent,  in  fact,  are  when  the  tension  on  the  tendon  is 
relaxed,  and  the  body-weight  altogether  removed  by  the 
animal  adopting  the  recumbent  position. 

The  compression  theory  as  to  the  causation  of  navicular 
disease  was,  we  believe,  first  originated  by  Colonel  Smith. 
He,  at  any  rate,  has  laid  much  stress  on  it  in  his  writings. 
If  we  accept  it,  and  we  see  every  reason  that  we  should, 
then  we  must,  with  the  author,  admit  the  possibility  of 
navicular  disease  arising  from  long  standing  in  one  position. 

3.  Concussion. -^-This  we  are  bound  to  admit  as  a  cause, 
and  in  so  doing  partly  explain  the  comparative,  almost  total, 
immunity  of  the  hind-feet  from  the  disease.  The  fore- 
limbs,  as  we  have  already  pointed  out,  are  little  more  than 
props  of  support,  and  the  force  of  the  propelled  body-weight 
is  transmitted  largely  down  their  almost  vertical  lines,  to 
end  largely  in  concussion  in  the  foot.  With  the  hind-limbs 
matters  are  different.  k  These,'  as  Percival  explains  it, 
'  have  their  bones  obliquely  placed,  so  as  to  constitute,  one 
with  the  other,  so  many  obtuse  angles,  to  the  end,  that  by 
forming  powerful  levers,  and  affording  every  advantage  for 
action  to  the  muscles  attached  to  them,  they  may  be  fitted 
for  the  purpose  of  propulsion  of  the  body  onward.' 

The  effect  of  these  several  obtuse-angled  joints  in  the 
limb  is  to  absorb  the  greater  part  of  the  force  exerted  by 
the  body-weight  before  it  reaches  the  foot.  When  with  this 
we  take  the  facts  that  the  fore-limbs  have  to  carry  the  head 
and  neck,  and  that  they  have  to  bear  this  added  weight, 
plus  a  propelling  force  from  behind,  we  see  why  it  is  that 
they  should  be  so  subject  to  the  disease,  and  the  hind-limbs 
so  exempt. 

As  pointing  out  the  part  that  concussion  plays  in  its 
causation,  we  may  mention  that  navicular  disease  is  a  disease 
of  the  middle-aged  and  the  worked  animal.  It  is  interesting 
to  note,  too,  that  it  occurs  in  animals  with  well  developed 
frogs — in  feet  in  which  frog-pressure  with  the  ground  is 


436        DISEASES  OF  THE  HORSE'S  FOOT 

most  marked.  This  at  first  sight  appears  to  flatly  con- 
tradict what  we  have  said  with  regard  to  frog-pressure  in 
other  portions  of  this  work.  With  this,  however,  must  be 
reckoned  other  predisposing  causes.  In  this  case  it  is  not 
to  frog-pressure  alone  we  must  look,  but  to  the  condition 
of  the  frog  itself,  and  that  of  the  neighboring  parts.  It 
is  when  we  have  a  frog  which,  though  well  developed  and 
apparently  satisfying  all  demands  as  to  size  and  build,  is  at 
the  same  time  composed  of  a  hard,  dry,  and  non-yielding 
horn  that  we  must  look  for  trouble. 

*  The  foot  predisposed  to  navicular  disease  is  the  strong, 
round,  short-toed  or  clubby  foot,  open  at  the  heels,  with  a 
sound  frog  jutting  prominently  out  between  them.  Here  is 
a  frog  exposed  to  all  the  pressure  that  might  be  desired  for 
it.  bounded  at  its  sides  by  heels  thick  and  strong,  and  in- 
disposed to  yield,  and  itself  liable,  from  its  very  exposure, 
to  become,  in  the  warm  stable,  hard  and  dry,  and  incom- 
pressible '  (Percival). 

Here,  instead  of  acting,  as  normally  it  should,  as  a  re- 
silient body,  and  an  aid  to  the  absorption  of  concussion,  it 
seems  rather  to  play  the  part  of  a  foreign  body,  and  to  bring 
concussion  about.  Seeing,  then,  that  the  navicular  bursa 
is  in  very  near  contact  with  it,  it  is  conceivable  that  this 
joint-like  apparatus  should  suffer,  and  the  pedal  articula- 
tion be  left  unaffected,  the  more  so  when  we  take  into  con- 
sideration the  compression  theory  just  described. 

4.  A  Weak  Navicular  Bone. — When  the  disease  com- 
mences first  in  the  bone — and  there  is  no  denying  the  fact 
that  sometimes,  although  not  invariably,  it  does — it  may  be 
explained  by  attributing  to  the  structure  of  the  bone  an 
abnormal  weakness  in  build. 

The  navicular  bone  consists  normally  of  compact  and 
cancellated  tissue  arranged  in  certain  proportions,  the  com- 
pact tissue  without,  and  the  cancellated  within.  These 
proportions  can  only  be  judged  of  by  the  examinations  of 
sections  of  the  bone,  and  when  it  is  found  in  any  case  that 
the  cancellated  tissue  bulks  more  largely  in  the  formation 
oi  the  bone  than  normally  it  should,  we  have  what  we  may 


DISEASES  OF  THE  JOINTS  437 

term  a  weak  navicular  bone.  In  this  connection  Colonel 
Smith  says:  'Though  it  is  far  from  present  in  every  case  of 
the  disease,  still  I  consider  it  a  factor  of  great  importance.' 

5.  A  Defective  or  Irregular  Blood-supply  to  the  Bone. — 
This.  Colonel  Smith  considers,  is  brought  about  by  excessive 
and  irregular  work,  and  by  the  opposite  condition — rest. 
The  author  points  out  that  the  bloodvessels  passing  to  and 
from  the  navicular  bone  run  in  the  substance  of  the  inter- 
osseous ligaments,  or  in  such  proximity  to  them  that  it  is 
conceivable  that  under  certain  circumstances  mechanical 
interferences  may  occur  to  the  navicular  circulation.  He 
further  points  out  a  fact  that  is,  of  course,  well  known  to 
every  veterinarian,  that  in  periods  of  work  the  circulation 
o\  the  foot  is  hurried,  and  that  in  rest  there  is  always  a 
tendency  to  congestion ;  and  he  says  in  conclusion :  '  I 
cannot  help  thinking  that  irregularities  in  the  blood- 
supply  in  a  naturally  weak  bone  must  be  a  factor  of  some 
importance,  especially  when  the  kind  of  work  the  horse  is 
performing  is  a  series  of  vigorous  efforts  followed  by  rest. 

6.  Senile  Decay. — With  approaching  age  the  various 
tissues  lose  their  vigour,  and  are  prone  to  disease.  The 
navicular  bone  and  surrounding  structurers  are  not  exempt. 
With  the  other  and  more  active  causes  we  have  described 
acting  at  the  same  time  it  is  not  surprising  that  navicular 
disease  is  seen  as  a  result. 

In  conclusion,  it  is  well,  perhaps,  to  say  that,  no  matter 
to  which  particular  theory  of  causation  we  may  lean,  we 
should  make  up  our  minds  to  consider  them  as  a  whole. 
While  one  cause  may  be  exciting,  the  other  may  be  pre- 
disposing, and  the  two  must  act  together  before  evil  results 
are  noticed.  It  may  be  that  even  more  than  two  are  con- 
cerned in  bringing  on  the  disease,  and  to  each  the  careful 
veterinarian  will  give  due  consideration. 

Symptoms  and  Diagnosis. — In  the  early  stages  of  navicu- 
lar disease  the  symptoms  are  obscure.  Pointing  of  the 
affected  limb  is  the  first  evidence  the  animal  gives.  This, 
however,  more  often  than  not,  goes  unnoticed,  and  the  first 
symptom  usually  observed  by  the  owner  or  attendant  is  the 


438        DISEASES  OF  THE  HORSES'S  FOOT 

lameness.  Even  this  is  such  as  to  at  first  occasion  no  alarm, 
being  intermittent  and  slight,  and  only  very  gradually  be- 
coming marked.  In  a  few1  cases,  however,  lameness  will 
come  on  suddenly,  and  is  excessive  from  the  commence- 
ment. It  is  the  lameness,  slow  in  its  onset,  intermittent  in 
its  character,  and  gradual  in  its  progress,  however,  that  is 
ordinarily  characteristic  of  navicular  disease. 

The  animal  is  taken  out  from  the  stable  sound,  with  just 
a  vague  suspicion,  perhaps,  that  he  moved  a  bit  stiffly. 
While  out  he  is  thought  by  his  driver  or  rider  to  be  going 
feelingly  with  one  foot  or  with  both.  Even  this  is  not 
marked,  and  the  driver  has  some  difficulty  in  assuring 
himself  whether  or  no  he  really  observed  it,  or  whether  it 
was  but  imagination. 

On  the  return  home  the  limb  is  examined,  and  nothing 
abnormal  is  to  be  found.  The  leg  is  of  its  normal  appear- 
ance, and  neither  heat  nor  tenderness  is  to  be  observed  in 
it  or  in  the  foot.  On  the  following  day  the  animal  again  is 
sound,  and  the  lameness  of  the  previous  day  is  put  down 
10  a  slight  strain  or  something  equally  simple.  The  patient 
is  then,  perhaps,  rested  for  a  day  or  two.  When  next  he  is 
worked  he  again  moves  out  from  the  stable  sound,  but  again 
during  the  going  gives  the  driver  the  unpleasant  impres- 
sion that  something  is  amiss ;  and  so  the  case  goes  on. 
One  day  the  owner  fears  the  animal  is  becoming  seriously 
enough  affected  to  warrant  him  in  calling  in  his  veterinary 
surgeon ;  the  next  he  is  confidently  assuring  himself  that 
nothing  is  wrong. 

Perhaps  the  animal  is  now  rested  for  a  week  or  two,  or 
even  for  a  month  or  two,  hoping  that  this  will  put  him 
sound.  Immediately  on  commencing  work,  however,  the 
same  symptoms  as  before  assert  themselves,  and  the  vet- 
erinary surgeon  is  called  in. 

With  a  history  such  as  we  have  given  the  veterinarian's 
suspicions  are  aroused.  He  has  the  animal  trotted,  and 
may  notice  at  this  stage  that  there  is  an  inclination  to  go 
on  the  toes,  that  the  lame  limb  or  limbs  are  not  put  forward 
freely,  and  that  progression  is  stilty  and  uncertain ;  it  is 


DISEASES  OF  THE  JOINTS  439 

such,  in  fact,  as  to  at  once  suggest  the  possibility  of  corns 
being  present. 

In  some  cases  there  is  just  the  suspicion  of  a  limp  with 
one  limb,  and  this  only  at  intervals  during  the  trot.  At- 
one moment  the  veterinarian  is  positive  that  he  sees  the 
animal  going  lame;  at  another  he  is  just  as  confident  he 
sees  him  coming  towards  him  sound. 

Nothing  is  found  in  the  limb — neither  heat,  tenderness, 
nor  swelling.  There  is  nothing  in  the  gait  (either  a  limited 
movement  of  the  radius,  or  a  circular  sweep  wTith  the  leg) 
to  indicate  shoulder  or  other  lameness,  and  the  veterinary 
surgeon,  by  eliminative  evidence,  is  bound  to  conclude  that 
the  trouble  is  in  the  foot. 

The  foot  is  then  examined — pared,  percussed,  pinched, 
and  in  other  ways  manipulated — but  nothing  further  is 
forthcoming.  In  such  a  case  the  veterinary  surgeon  is 
wise  to  declare  the  abortive  result  of  his  examination,  to 
hint  darkly  of  his  suspicions,  and  to  suggest  a  second  ex- 
amination at  some  future  date.  It  may  be  that  two,  three, 
four,  or  even  more,  such  examinations  are  necessary  before 
he  can  justly  pronounce  a  positive  verdict. 

Later  he  is  enabled  to  do  this  by  an  increase  in  the 
severity  of  the  symptoms,  and  by  the  changes  that  take 
place  in  the  form  of  the  foot.  The  lameness  is  now  more 
marked,  and  the  '  pointing '  in  the  stable  more  frequent. 
With  regard  to  the  latter  symptom,  it  has  been  seriously 
discussed  whether  the  horse  with  navicular  disease  points 
with  the  heel  elevated  or  with  it  pressed  to  the  ground.  In 
either  case,  of  course,  the  limb  is  advanced ;  but  while  some 
hold  that  the  phalangeal  articulations  are  flexed  and  the 
heel  slightly  raised,  in  order  to  relieve  the  pressure  of  the 
perforans  tendon  on  the  affected  area,  and  so  obtain  ease, 
there  are  others  who  hold  that  the  heel  is  pressed  firmly  to 
the  ground  in  order  to  deaden  the  pain.  It  may  be,  and 
most  probably  is,  that  both  are  right ;  but,  in  our  opinion, 
there  is  no  doubt  whatever  that  pointing  with  the  heel 
eievated  is  by  far  the  most  common. 

The  lameness  is  now  excessive,  and  is  especially  notice- 


440        DISEASES  OF  THE  HORSE'S  FOOT 

able  when  the  animal  is  put  to  work  on  a  rough  or  on  a 
hard  ground.  Even  now,  however,  heat  of  the  foot  or 
tenderness  is  so  slight  as  to  be  out  of  all  proportion  to  the 
alteration  in  gait. 

With  the  case  thus  far  advanced,  evidence  of  pain  may 
be  obtained  by  pressing  with  the  thumb  in  the  hollow  of  the 
heel.  Evidence  of  pain  may  also  be  obtained  by  using  the 
farrier's  pincers  on  the  frog.  These  methods,  however,  are 
never  wholly  satisfactory,  as  a  horse  with  the  soundest  of 
feet  will  sometimes  flinch  under  these  manipulations. 

Extreme  and  forcible  flexion  of  the  corono-pedal 
articulation  also  sometimes  gives  evidence  of  tenderness. 
In  this  case  the  foot  is  held  up,  the  animal's  metacarpus 
resting  on  the  operator's  knee,  and  the  toe  of  the  hoof 
pushed  downwards  with  some  degree  of  force. 

The  same  movement  of  the  joint  is  given  by  causing  the 
animal  to  put  full  weight  upon  the  diseased  limb,  a  small 
wedge  of  wood  being  first  placed  under  the  toe.  In  this 
manner  the  pressure  of  the  perforans  tendon  upon  the 
bursa  is  greatly  increased,  and  the  animal  is  caused  to 
show  symptoms  of  distress. 

The  lameness  may  also  be  increased,  and  diagnosis 
helped,  by  paring  the  heels,  so  as  to  leave  the  frog  promi- 
nent and  take  the  whole  of  the  body-weight.  The  same 
end  is  also  obtained  by  applying  a  bar  shoe.  This  was 
originally  pointed  out  by  Brauell,  and  is  quoted  by  Zundel 
and  by  Moller. 

The  changes  in  the  form  of  the  hoof  may  now  be  noticed. 
These  are  largely  dependent  on  the  fact  that  more  or  less 
constantly  the  patient  saves  the  heel.  The  horn  of  the 
walls  in  this  region,  and  the  horn  of  the  frog,  is  thereby 
put  out  of  action  and  induced  to  atrophy.  The  hoof 
gradually  assumes  a  more  upright  shape,  and  the  heels 
contract.  We  thus  get  a  hoof  which  is  visibly  narrowed 
from  side  to  side,  with  a  frog  that  is  atrophied  and  often 
thrushy,  and  with  a  sole  that  is  abnormally  concave,  hard, 
and  affected  with  corns. 

When   occurring   in   the   hind-feet — a    condition   that   is 


DISEASES  OF  THE  JOINTS  441 

rare,  but  which  has  been  noticed  by  Loiset,  and  quoted  by 
Zundel — the  animal  is  stiff  behind,  walks  on  his  toes,  and 
gives  one  the  impression  that  he  is  suffering  from  some 
affection  in  the  region  of  the  loins. 

One  such  case  is  reported  by  an  English  veterinary 
surgeon,  and  we  quote  it  here: 

'  A  gray  gelding,  and  a  capital  hunter,  the  property  of 
a  gentleman  in  this  neighborhood,  became  lame  in  the 
near  fore-foot  after  the  hunting  season  of  1859.  The  lame- 
ness was  believed  to  be  due  to  navicular  disease.  The 
operation  of  neurectomy  was  ultimately  had  recourse  to. 
The  horse  subsequently  did  his  work  as  well  as  ever,  and 
was  ridden  to  hounds  regularly  till  the  end  of  the  year 
1861,  when  he  went  lame  of  the  off  fore-foot.  From  this 
date  he  also  showed  very  peculiar  action  behind,  and  was 
at  times  lame  on  both  hind-limbs  without  any  apparent 
cause. 

'  In  the  year  1862,  from  the  groom's  indiscreet  use  of 
physic,  superpurgation  was  brought  on  which  caused  the 
animal's  death.  On  a  post-mortem  examination  being 
made,  the  horse  was  found  to  have  navicular  disease  of  all 
four  feet.  It  is  worthy  of  note  that  this  horse  had  always 
"  extravagant  "  action  behind,  but  was  a  remarkably  quick 
and  good  jumper.'* 

Differential  Diagnosis. — Navicular  disease  may  be  mis- 
taken for  ordinary  contracted  foot.  It  will  be  remembered, 
however,  that  in  the  early  stages  of  navicular  disease  con- 
traction is  absent,  and  that  it  is  only  when  the  disease  in 
the  bursa  is  of  long  standing  that  contraction  comes  on. 
With  ordinary  contracted  foot,  too,  careful  paring  and 
suitable  shoeing  soon  sees  a  diminution  in  the  degree  of 
lameness,  and  a  return  to  the  normal  in  shape  (see  Treat- 
ment of  Contracted  Foot,  p.  125).  With  navicular  disease, 
however,  such  shoeing  as  is  beneficial  in  the  treatment  of 
contracted  foot  (notably  the  various  methods  of  giving  to 
the  frog  counter-pressure  with  ground  )  soon  brings  on  an 
aggravation  of  the  lameness. 

*  F.  Blakeway,  M.R.C.V.S..  Veterinarian,  vol.  Hi.,  p.  21. 


442         DISEASES  OF  THE  HORSE'S  FOOT 

It  is,  perhaps,  even  more  likely  to  be  confounded  with 
contraction  when  we  have  with  the  contraction  a  state  of 
atrophy  and  thrush  of  the  frog.  With  a  frog  in  this  condi- 
tion pressure  will  give  rise  to  pain,  and  navicular  disease  be 
erroneously  judged  to  be  present.  In  such  a  case  we  must 
rely  wholly  upon  either  extreme  flexion  or  extreme  exten- 
sion of  the  joint  to  guide  us,  when,  if  contraction  only  is  the 
offending  condition,  no  symptom  of  pain  will  be  shown. 

Navicular  disease  may  also  be  confused  with  rheumatic 
affections,  with  sprain  of  the  posterior  ligaments  of  the  first 
interphalangeal  articulation,  and  with  sesamoid  lameness. 
Mistakes  are  sometimes  made,  too,  especially  with  a  hasty 
observer,  in  confounding  it  with  shoulder  lameness. 

In  rheumatism  the  constant  changing  of  the  seat  of  pain, 
the  sometimes  elevated  temperature,  and  the  appearance  of 
symptoms  of  heat,  tenderness,  and  swelling  in  the  affected 
area  should  guide  one  to  a  right  conclusion. 

In  sprain  of  the  posterior  ligaments  of  the  coronet  and  in 
sesamoid  lameness,  nothing  but  a  careful  examination  and 
manipulation  of  the  parts  will  ward  off  error,  for  in  each,  of 
these  cases  there  is  '  pointing '  and  resting  of  the  limb,  and 
considerable  disinclination  to  put  weight  firmly  upon  it. 
If  at  the  same  time  manipulation  gives  distinct  evidence  of 
pain,  all  doubt  may  be  set  at  rest. 

Roughly  speaking,  sesamoid  lameness  is  a  condition  of 
the  gliding  surface  of  the  sesamoids,  and  the  face  o£  the 
tendon  playing  over  them,  similar  to  that  found  in  navicular 
disease.  All  symptoms  of  pointing,  the  constant  main- 
taining of  the  limb  in  a  state  of  flexion,  and  a  feeling 
manner  of  progression  are  again  all  present.  It  is  plain 
from  this  that  in  all  cases  where  an  animal  with  a  gait  at  all 
suggestive  of  navicular  disease  is  brought  for  our  examina- 
tion, the  manipulation  of  the  limb  should  be  thorough. 
The  character  of  the  lameness  is  almost  sure  to  deceive  us ; 
and  it  is  not  until  we  are  able  to  obtain  local  symptoms 
pointing  to  the  one  or  the  other  of  the  conditions  we  have 
enumerated  that  a  decisive  opinion  may  be  given.  In 
sesamoid  lameness  the-  local  symptoms  are  those  of  heat 


DISEASES  OF  THE  JOINTS  443 

and  pain  in  the  fetlock  on  palpation,  and  a  swelling  of  the 
affected  parts,  such  swelling  being  at  first  slight,  yielding, 
and  barely  distinguishable,  and  afterwards  larger,  bony  and 
hard,  and  more  marked.  Later  still  there  is  distinct  evidence 
of  'knuckling'  over  at  the  fetlock  and  inability  to  fully  flex  it. 

In  cases  of  shoulder  lameness  the  gait  alone  should  be 
sufficient  to  render  liability  of  error  small,  for  with  nearly 
every  case  there  is  a  manifest  inability  to  '  get  the  limb 
forward,'  and  this  is  best  seen  at  a  side  view  when  the 
animal  is  trotting  past  the  observer.  When  trotting  towards 
one,  there  is  a  further  and  unmistakable  symptom  common 
to  most  shoulder  lamenesses  that  serves  to  distinguish  it  at 
once,  and  that  is  the  peculiar  '  sweeping '  outwards  with 
the  affected  limb. 

Lastly,  with  either  of  the  conditions  we  have  just 
mentioned,  it  is  the  exception  to  let  contracted  foot  follow 
on.  With  navicular  disease  it  sooner  or  later  makes  its 
appearance. 

Prognosis. — The  prognosis  of  navicular  disease  (once 
diagnosed  with  certainty)  must  almost  of  necessity  be 
unfavourable.  The  facts  that  the  disease  has  made  serious 
progress  before  it  is  really  noticeable,  that  the  situation  of 
the  parts  prohibits  operative  interference,  and  that  the 
disease  is  one  of  a  chronic  and  slowly  progressive  type,  all 
point  to  an  unfavourable  termination. 

Treatment. — We  have  seen  from  the  pathology  of  this 
disease  that  it  may  commence  either  as  a  rarefactive  ostitis, 
or  as  a  synovitis  and  tenositis  in  connection  with  the  bursa. 
With  the  former  condition  in  existence,  or  when  this  and 
the  synovitis  has  led  to-  erosion  of  the  cartilage,  treatment 
is  probably  of  no  avail,  on  account  of  the  more  chronic 
nature  of  these  two  conditions.  When,  however,  the  con- 
dition is  simply  that  of  synovitis  or  tenositis,  a  more  or  less 
acute  condition,  we  may  assume  that  suitable  treatment  and 
a  long  rest  will  bring  about  resolution. 

The  first  indications  in  treatment  are  those  of  what  we 
may  term  '  nursing '  the  foot.  It  should  have  sufficient 
rest,  should  be  placed  so  as  to  minimize  as  far  as  possible 


444        DISEASES  OF  THE  HORSE'S  FOOT 

compression  of  the  parts,  and  should  have  its  posterior 
half  treated  so  as  to  render  it  softer  and  less  liable  to 
concussion. 

The  period  of  rest  required  cannot  be  satisfactorily 
advised,  and  the  practitioner  is  wise  who  makes  it  a  long 
one.  Rest  should  be  advised,  in  fact,  long  after  symptoms 
of  lameness  have  disappeared  and  recovery  is  judged  to 
have  taken  place. 

Compression  of  the  parts  may  be  somewhat  minimized,  if 
the  animal  be  kept  in  the  stable,  by  allowing  the  floor  upon 
which  the  front-feet  are  to  stand  to  be  slightly  sloping  from 
behind-  forwards.  The  same  effect,  though  not  so  marked, 
is  obtained  by  removing  the  shoes,  and  considerably  lower- 
ing the  wall  at  the  toe,  while  allowing  that  of  the  heels  to 
remain.  It  may  here  be  remarked  that  it  is  a  good  practice 
to  allow  the  shoes  to  remain  on,  and  this  even  when  the 
animal  is  at  grass.  They  should,  however,  be  frequently 
removed,  and  the  foot  trimmed  as  we  have  directed. 

With  the  foot  thus  trimmed  so  as  to  most  suitably  adjust 
the  angles  of  the  articulations,  it  should  next  be  thoroughly 
pared  and  rasped  in  its  posterior  half,  so  as  to  render  the 
horn  of  the  sole  and  the  frog  and  the  horn  of  the  quarters 
as  thin  as  possible.  The  heels,  however,  should  not  be  ex- 
cessively lowered,  if  at  all.  We  now  have  the  foot  in  a  soft 
condition,  and  easily  expanded.  It  should,  if  possible,  be 
kept  so ;  and  this  may  be  done  either  by  the  use  of  poultices, 
by  tepid  baths,  or  by  standing  the  animal  upon  a  bedding 
that  may  easily  be  kept  constantly  damp.  Such  materials 
as  tan,  peat  moss,  or  sawdust,  are  either  of  them  suitable. 

All  this,  of  course,  calls  for  keeping  the  animal  in  the 
stable.  It  is  far  better,  however,  more  especially  if  a  piece 
of  marshy  land  is  at  hand,  to  turn  him  out  in  that.  A 
moderate  amount  of  exercise  is  beneficial  rather  than  not, 
and  the  feet  are  thus  constantly  kept  damp  without  trouble 
to  the  attendants. 

The  second  indication  in  the  treatment  is  that  of  applying 
a  counter-irritant  as  near  to  the  diseased  parts  as  possible. 
Regarding  its  efficacy  we  must  confess  to  being  somewhat 


DISEASES  OF  THE  JOINTS  445 

sceptical.  The  treatment  has  been  constantly  practised  and 
advised,  however,  and  we  feel  bound  to  give  it  mention  here. 
A  smart  blister  may,  therefore,  be  applied  to  the  whole  of 
the  coronet,  and  need  not  be  prevented  from  running  into 
the  hollow  of  the  heel. 

Instead  of  blistering  the  coronet  (or  in  conjunction  with 
that  treatment),  the  counter-irritant  may  be  applied  by 
passing  a  seton  through  the  plantar  cushion  or  fibro-fatty 
frog.  Setoning  the  frog  appears  to  have  been  introduced 
by  Sewell.  In  many  cases  great  benefit  is  claimed  to  have 
been  derived  from  it,  especially  by  English  veterinarians  of 
Sewell's  time,  and  by  others  on  the  Continent.  Percival, 
however,  was  not  an  advocate  for  it,  and,  at  the  present 
day,  it  is  a  practice  which  appears  to  have  dropped  out  of 
use  altogether. 


Fig.   164.— Frog  Seton   Needle. 

To  perform  this  operation  a  seton  needle  of  a  curved 
pattern  is  needed  (see  Fig.  164).  This  is  threaded  with 
a  piece  of  stout  tape  dressed  with  a  cantharides,  hellebore, 
or  other  blistering  ointment,  and  then  passed  in  at  the 
hollow  of  the  heel,  emerging  at  the  point  of  the  frog.  The 
course  the  needle  should  take  will  be  understood  from  a 
reference  to  Fig.  165. 

The  seton  may  be  passed  with  the  horse  in  the  standing 
position.  Previously  the  point  of  the  frog  should  be  thinned, 
and  the  animal  should  be  twitched.  After-treatment  consists 
simply  in  moving  the  seton  daily,  and  dressing  it  occasion- 
ally with  any  stimulating  ointment,  or  with  turpentine. 

If,  in  spite  of  these  treatments,  the  disease  persists,  then 
nothing  remains  but  neurectomy. 


446        DISEASES  OF  THE  HORSE'S  FOOT 

D.     DISLOCATIONS. 

The  firm  and  rigid  manner  in  which  the  bones  of  the 
pedal  articulation  are  held  together  renders  dislocation  of 
this  joint  an  exceedingly  rare  occurrence,  and  then  it  is 
only  liable  to  happen  under  the  operation  of  great  force. 
In  the  literature  to  our  hand  we  have  only  been  successful 
in  discovering  one  reported  instance,  and,  strange  to  say, 
in  this,  a  well-marked  case,  the  cause  was  altogether 
obscure.    We  quote  the  case  at  the  end  of  this  section. 


a-. 


Fig.  165. — Diagram  showing  the  Course  taken  by  the  Needle 
when  Setoning  the  Frog. 

This  is  shown   by  the  dotted  curved  line  a,  b. 

r,  The  navicular  bone ;  2,  the  plantar  cushion ;  3,  the  os  pedis ;  4,  the 
perforans  tendon. 

A  partial  dislocation  of  this  articulation  is  the  condition 
met  with  in  '  Buttress  Foot.'  In  this  case  the  fracture  of 
the  pyramidal  process,  and  the  consequent  lengthening  of 
the  tendon  of  the  extensor  pedis,  allows  the  os  coronse  to 
occupy  upon  the  articulatory  surface  of  the  os  pedis  a  more 
backward  position  than  normally  it  should. 

It  is  quite  probable,  too,  that  slight  lesions  of  the  other 
restraining  ligaments  and  tendons  of  the  articulation  may 


DISEASES  OF  THE  JOINTS  447 

bring  about  a  similar  though  less  marked  condition.  We 
may  be  quite  sure  of  this — that  whenever  such  lesions  i  as. 
for  example,  sprain  and  partial  rupture  of  the  lateral  liga- 
ments )  do  occur,  and  the  normal  position  of  the  opposing 
bones  is  changed,  if  only  slightly,  that  great  pain  and 
excessive  lameness  must  be  the  result,  and  this  with  but 
little  show  in  the  foo.t.  Many  of  our  cases  of  obscure 
foot  lameness  might,  if  capable  of  demonstration,  turn  out 
to  be  cases  of  sprain  and  partial  dislocation  of  the  pedal 
articulation. 

Recorded  Case. — '  The  animal,  a  trooper  of  the  8th  Hus- 
sars, was  found  on  the  morning  of  April  17  unable  to. 
bear  any  weight  on  the  limb  (the  near  hind).  Cause  not 
known — the  heel-rope  I  thought  at  first ;  but  on  investiga- 
tion I  found  the  heel-rope  had  been  on  the  other  leg. 

'Diagnosis. — Dislocation  of  the  left  os  coronae  from  the 
articulating  surface  of  the  os  pedis  in  a  backward  direction. 

'  Every  devisable  means  were  unsuccessful  in  reducing 
the  limb  to  its  natural  position.  The  horse  was  thrown, 
and  a  strong  rope,  with  four  men  pulling  at  it,  was  fastened 
round  the  hoof,  whilst  I  put  my  knee  to  the  back  of  the 
pastern,  using  all  possible  force,  with  one  hand  to  the  foot 
and  the  other  to  the  fetlock,  but  all  to  no  purpose.  Next 
day  other  means  were  tried.  First  by  throwing  the  horse 
and  placing  him  on  his  belly,  with  the  fore-legs  stretched 
out  forwards,  and  the  hind-legs  backwards.  This  I  did  so 
a4',  to  get  the  injured  limb  placed  as  nearly  flat  on  the 
ground  as  possible,  with  its  anterior  aspect  downwards. 
Then  a  very  heavy  man,  with  his  boots  off,  was  made  to 
jump  on  the  back  of  the  pastern,  where  the  prominence 
showed  most ;  and  afterwards,  when  these  means  failed, 
a  strong  piece  of  wood,  well  covered  with  leather,  was 
placed  (where  the  hollow  of  the  heel  ought  to  have  been  ) 
on  the  most  prominent  part,  and  hit  several  times  with  a 
heavy  hammer  ;  but  all  efforts  were  futile. 

'Prognosis. — Unfavorable.  During  the  latter  operations 
I  had  a  very  strong  pressure  applied  to  the  hoof,  and  the 
horse   firmly   fastened   in   every   way.   and   it   appeared   as 


448        DISEASES  OF  THE  HORSE'S  FOOT 

though  no  amount  of  force  would  ever  reduce  the  dis- 
location. 

'  Tautological. — The  case  was  destroyed  on  April  30, 
being  of  no  further  use  to  the  service. 

'  Post-mortem. — The  os  coronae  was  found  to  have  slipped 
out  of  the  articulating  cavity  of  the  os  pedis,  backwards 
and  past  the  lateral  ligaments.  These  last-named  struc- 
tures prevented  the  bone  being  forced  forward  into  its 
proper  position,  being  firmly  locked  over  the  lateral  pro- 
minences. The  capsular  ligament  was  considerably  lacerated 
and  inflamed,  causing  slight  effusion  and  swelling  about  the 
region  of  the  coronet.'* 

Treatment. — After  the  forcible  means  of  reduction  related 
by  Mr.  Flintoff,  we  may  add  that  when  they  are  successful, 
they  should  be  followed  by  suitable  bandaging  of  the  parts, 
and  rest.  The  first  is  effected  by  applying  plaster  of  Paris 
and  linen,  and  the  second  by  having  the  animal  put  in 
slings. 

*  T.  Flintoff,  A.V.D.,  Veterinary  Journal,  vol.  xix.,  p.  74. 


INDEX 


Accidental    tearing    off    of    the 

entire  hoof_,  247 
Acute  arthritis,  417 

causes    of,   417 

symptoms  of,  418 

treatment  of,  424 
Acute  laminitis,  256 

causes  of,  256 

complications  in,  267 

congestion,  in  264 

course  of,  264 

definition  of,  256 

diagnosis  in,  271 

exudation  in,  265 

pathological    anatomy  of,  264 

prognosis  in,  271 

suppuration  in,  267 

symptoms  of,  260 

treatment  of,  272 
Acute  periostitis,  simple,  382 
Acute  simple  coronitis,  229 

causes  of,  229 

definition  of,  229 

symptoms  of,  23i 

prognosis  of,  234 

treatment  of,  23$ 
Acute  simple  synovitis,  41 3 
Advantages  of  neurectomy,  107 
Amputational       neuroma       after 

neurectomy,   104 
Anatomy,    pathological,    of   corn. 

191 
Applying  poultices,  method  of,  86 
Arteries  of  the  foot,  22 
Arthritis,  acute,  417 

causes  of,  417 

symptoms  of,  418 

treatment  of,  424 
Arthritis,   suppurative,  418 

causes  of,  418 

definition   of,  418 

diagnosis  of,  419 

pathology  of,  422 

symptoms  of,  419 

treatment  of,  424 


Articulation,  the  first  interphalan- 

geal,  12 
Articulation,    the    second    inter- 

phalangeal,   15 

Bar  pad  and  a  half-shoe  in  the 

treatment    of    contracted    feet, 

129 
Bar   shoes    in    the    treatment    of 

contraction,   128 
Bayer's     treatment     for    chronic 

laminitis,  291 
Bermbach's  treatment  for  canker, 

321 

Bind,  205 

Bone,  carries  of,  387 

Bones,    fracture    of    the,    after 

neurectomy,   104 
Bones,  fracture  of  the,  401 
Bones,  necrosis  of,  387 
Bones,  the,  7 
Brittle  hoof.    150 

causes  of,  151 

definition    of,    150 

symptoms  of,  150 

treatment  of,  151 
Broad's    treatment    of    laminitis, 

274„ 
Broue's   expansion  shoe,   i3; 

Bruised  sole,  chronic,  2o3 

Buttress  foot,  395 

Canker,  3o6 

Bermbach's  treatment  of,  32i 
causes  of,  3o6 
definition  of,  3o6 
differential    diagnosis   in,  3 14 
history  of,  3o6 
Hoffman's    treatment   of,  32i 
Imminger's       treatment     of, 

321 

Malcolm's  treatment  of.  3 16 
pathological  anatomv  of,  3To 
prognosis  in,  314 
Rose's  treatment  of,  322 
symptoms  of,  3 10 
treatment  of,  3ia 
U9 


450         DISEASES  OF  THE  HORSE'S  FOOT 


Caries  of  bone,  387 

Caries  of  the  os  pedis  in  pricked 

foot,  217 
Cartilage,  the  lateral,  3o 
Cartilaginous  quittor,  337 
Causes  of  acute  laminitis,  256 
of  acute  simple  coronitis,  229 
of  brittle  hoof,  151 
of  canker,  3o6 
of  chronic  coronitis,  240 
of  chronic  laminitis,  282 
of  club-foot,  155 
of  corn,  i83 
of  contracted  feet,  121 
of  coronary  contraction  of  the 

foot,   140 
of  crooked    foot,    158 
of  curved  hoof,  i^g 
of  false  quarter,  246 
of  flat-foot,   144 
of  keraphyllocele,  298 
of  nail-bound,  205 
of  navicular  disease,  433 
of  pumiced  foot,  146 
of  punctured  foot,  207 
of  ringed  hoof,  149 
of  sand-crack,  162 
of  seedy-toe,  293 
of  side-bone,  368 
of  simple    chronic    coronitis, 

240 
of  simple  cutaneous    quittor, 

330 
of  specific  coronitis,  325 
of  sub-horny  quittor,  335 
of  trush,  303 
of  weak  heels,  116 
Caustic  solution,  Villate's,   199 
Changes  in  the  bone  in  navicular 
disease,  431 
in    the    bursa    in    navicular 

disease,  429 
in  the  cartilage  in  navicular 

disease,  430 
in  the  internal  structures  of 
the  foot  in  contraction,  120 
in    the    tendon    in    navicular 
disease,  431 
Charlier  shoe,  the,  126 
Charlier   shoeing   for  contracted 

foot,  126 
•Chemical  properties  of   horn,  58 
Chronic  coronitis,  simple,  240 
causes  of,  240 
definition   of,  240 
symptoms  of,  241 
treatment  of,  242 
Chronic  bruised  sole,  203 
treatment  of,  204 


Chronic  laminiJs,  282 

Bayer's  treatment  of,  291 
causes  of,  282 
definition  of,  282 
Gross's  treatment  of,  291 
Gunther's  treatment  of,  291 
'rnminger's  treatment  of,  291 
Joly's  treatment  of,  292 
Meyer's  treatment  of,  291 
pathological  anatomy  of,  287 
surgical  shoeing  for,  291,  292 
symptoms  of,  283 
treatment  of,  289 
treatment  of,  by  ligaturing  the 
digital  arteries,  292 
Chronic  oedema  of  the  leg  after 

neurectomy,  104 
Chronic  synovitis,  415 
Clamp,  sand-crack,  Koster's,  173 
McGill's,  172 
Vachette's,  171 
Clamping    sand-cracks,    methods 

of,  171 
Classification  of  corns,  183 

of  punctured  foot  according 
to    the    situation    of    the 
wound,  209 
of  sand-crack,  161 
of  quittor,  329 
Club-foot,    153 
causes  of,  155 
definition  of,  153 
symptoms  of,  154 
treatment  of,  155 
Cocaine   injections   as   an   aid  to 
diagnosis  in  foot  lameness,  74 
Colic,  metastatic,  in  laminitis,  268 
Commencement,  point  of,  in  na- 
vicular disease,  428 
Common  situations  of  the  wound 

in  punctured  foot,  209 
Complicated    sand-crack,    opera- 
tions for,  180 
Complications  in  coronitis,  232 
in  laminitis,  267 
in  pricked  foot,  214 
in  sand-crak,  168 
in  simple  or  cutaneous  quit- 
tor,  332 
in  sub-horny  quittor,  337 
Compression  as  a  cause  of  navi- 
cular   disease,    433 
Concussion   as   a  cause  of  navi- 
cular disease,  4.35 
Conformation,   faulty,   155 
Congestion  in  laminitis,  264 
Contracted  foot,  116 
causes  of,  121 


IXDEX 


451 


changes      in      the      internal 
structures  of,  120 

definition  of,   116 

local  or  coronary,  140 

prognosis  of,  124 

surgical  shoeing  for,  125-137 

symptoms  of,  117 

treatment  of,  125 
Contraction    of    the    foot,    a   bar 
pad  and  a  half-shoe  in  the 
treatment  of,  I2g 

bar    shoes    in    the   treatment 
of  128 

expansion  shoes  in  the  treat- 
ment of,  130 
Corn,  182 

causes  of,  183 

classification   of,    183 

definition  of,  182 

pathological  anatomy  of,  191 

prognosis  in,  196 

surgical   shoeing  in,   200 

symptoms  of,  190 

the  dry,   191 

the  moist,  195 

the  suppurating,  195 

treatment  of,  197 
Coronary     contraction     of     the 
foot,  140 

causes  of,  140 

definition  of,  140 

symptoms  of,  140 

treatment  of,  143 
Coronary  cushion,  the,  33 
Coronary  edge  of  the  wall,  expan- 
sion and  contraction  of  the,  65 
Coronitis,  acute  simple,  229 

causes  of,  229 

complications    in,    232 

definition  of,  229 

prognosis  of,  234 

symptoms  of,  231 

treatment  of,  235 
Coronitis,  simple  chronic,  240 

causes  of,  240 

definition  of,  240 

symptoms  of.  241 

treatment  of,  242 
Coronitis,  specific,  324 

causes  of,  325 

definition  of,  324 

symptoms  of,  325 

treatment  of,  326 
Course  of  acute  laminitis,  264 
Crooked  foot,  157 

causes  of,  158 

definition  of.  157 

symptoms    of,    157 

treatment  of,   158 


Curved  hoof,  159 

causes  of,  159 

definition  of,  139 

treatment  of,  160 
Cushion,  the  coronary.  33 

the  plantar,  32 
Cutaneous  or  simple  quittor,  330 

De  Fay's  expansion  shoe,  133 
Defective     or     irregular     blood- 
supply  to  the  bone  a  cause  of 
navicular  disease,  437 
Definition  of  acute  laminitis,  256 

of  acute  simple  coronitis,  229 

of  brittle  hoof,  150 

of  canker,  306 

of  chronic  coronitis,  240 

of  chronic  laminitis,  282 

of  club-foot,  153 

of  contracted  foot,  116 

of  corn, 182 

of   coronary    contraction    of 
the  foot,  140 

of  crooked  foot,  157 

of  curved  hoof,   159 

of  false  quarter,  243 

of  flat-foot,  143 

of  keraphyllocele,  298 

of  nail-bound.  205 

of  navicular  disease,  427 

of  pumiced  foot,  146 

of  punctured  foot,  207 

of  pyramidal  disease,  395 

of  quittor,  329 

of  ringed  hoof,  149 

of  sand-crack,  161 

of  seedy-toe,  293 

of  sidebone,  363 

of  simple    chronic    coronitis, 
240 

of  specific  coronitis,  324 

of  spongy  hoof,  152 

of  sub-horny  quittor,  335 

of  thrush.  303 

of  weak  heels,  115 
Develooment  of  the  hoof,  44 
Diagnosis  of  acute  laminitis,  271 

of  canker,  314 

of  foot  lameness  by  injections 
of  cocaine,  74 

of  navicular  disease,  437 

of  punctured  foot,  210 

of  pyramidal  disease.  396 

of  side-bone,  363 

of  sub-horny  quittor,  336 
Differential  diagnosis  in  canker, 

.   3H  . 

in  navicular  disease,  441 


452 


DISEASES  OF  THE  HORSE'S  FOOT 


Diseases  arising  from  faulty  con- 
formation, 161 

Dislocation  of  the  os  coronae, 
recorded  case  of,  447 

Dislocations,  446 

Dry  corn,  191 

Einsiedel's  expansion  shoe,   136 
Examining  the  foot,  method  of, 

70,  72,  74 
Exercise,  forced,  in  the  treatment 

of  laminitis,  274 
Expansion  and  contraction  of  the 
coronary  edge  of  the  wall, 

65 
of  the  hoof  under  the  body- 
weight,  62 
of  the  solar  edge  of  the  wall, 

65 

of  the  sole,  66 
Expansion  shoe,  Broue's,  135 
De  Fay's,  133 
Einsiedel's,   136 
Hartman's   134 
Smith's,  130 
Expansion  shoes  in  the  treatment 

of  contraction,  130 
Extensor  oedis  tendon,  the,  17 
Extirpation  of  the  lateral  cartilage 
in  quittor,  351 
of  the  lateral  cartilage,  after 

Moller  and  Frick,  353 
of  the  lateral  cartilage  after 
Bayer,  355  _ 
Exudation  in  laminitis,  265 

False  quarter,  245 

causes  of,  246 

definition  of,  245 

symptoms  of,  245 

treatment  of,  246 
Faulty  conformation,  115 

diseases  arising  from,  161 
Feeding  a  cause  of  laminitis,  2^7 
Flat-foot,   143 

causes  of,  144 

definition  of,  143 

symptoms  of,  143 

treatment  of,  145 
Flexor    oedis    perforans    tendon, 

the,  18 
Flexor  pedis  perforatus  tendon, 

the,  19 
Foot,  buttress,  395 
Foot,    changes    in    the     internal 
structures    in    contraction    of 
the,  20 
Foot  contracted,  116 

causes  of,  121 


definition  of,  116 

prognosis  of,  124 

symptoms  of,  117 

treatment  of,  125 
Forced  exercise  in  laminitis,  274 
Fractures,  401 

Fractures    of    the    bones     after 
neurectomy,  104 

of  the  navicular  bone,  408 

of  the  os  coronae,  402 

of  the  os  pedis,  407 
Frog,  the,  42 

Functions     of     the    lateral    car- 
tilages, 66 

Gangrence  of  the  sensitive  struc- 
tures in  laminitis,  268 
Gathered  nail,  207 
Gelatinous      degeneration     after 

neurectomy,  102 
Grooving    the   wall    in    laminitis 
(Smith's  operation),  278 
in  treatment   of   sand-crack, 

in    treatment    of    side-bone 
(Smith's  operation),  372 
Gross's     treatment     of     chronic 

laminitis,  291 
Growth  of  hoof,  rate  of,  69 
Gunther's    treatment    of   chronic 
laminitis,  291 

Hartmann's  expansion  shoe,  134 
Heels,  weak,  115 
causes  of,  116 
definition  of,  115 
symptoms  of,  115 
treatment  of,  116 
Heredity  as  a  cause  of  navicular 
disease,  433 
as  a  cause  of  side-bone,  370 
Histology  of  horn,  58 
History  of  canker,  306 

of  navicular  disease,  428 
of  neurectomy,  91 
Hind-feet    navicular    disease    in 

the,  441 
Hind-limb     with     the     side-line, 

method  of  securing,  78,  79 
Hoffmann's  treatment  of  canker, 

321 
Hoof,  the,  XI 

accidental  tearing  off  of,  247 
expansion   and  contraction  of, 

62 
development  of,  44 
rate  of  growth  of,  69 
Horn,  chemical  properties  of,  58 

histology  of,   s§ 
Huflederkitt,   148,  292 


INDEX 


453 


Imminger's  treatment  of  chronic 
laminitis,  291 
for  canker,  321 
Immobilizing    a    sand-crack    by 
grooving  the  wall,  methods  of, 

Infection  of  the  limb,  septic,  271 
Injections  of  cocaine  as  an  aid  to 
diagnosis  in  foot  lameness,  74 
Interphalangeal  articulation,    the 
first,  12 
the  second,  15 
Instruments    required   in   plantar 
neurectomy,  q6 
in  operation  of  the  foot,  83 
Irregular     blood-supply     to     the 
bone  as   a   cause  of   navicular 
disease,  437 

Joly's  treatment  of  chronic  lami- 
nitis, 292 

Koster's  sand-crack  clamp,   173 
Keraphyllocele,   208 

causes>  of,  298 

definition  of,  298 

pathological  anatomy  of,  301 

symptoms  of,  300 

treatment  of,  302 
Keratoma,  302 

Lameness,   cocaine  injections   as 

an  aid  to  diagnosis  in.  74 
Lamina?,  the  sensitive,  36 
Laminitis,  acute,  256 

Broad's  treatment  of,  274 

causes  of,  256 

complications  in.  267 

congestion  in,  264 

course  of,  264 

definition  of,  256 

diagnosis  in,  271 

exudation  in,  265 

feeding,  a  cause  of.  257 

forced  exercise  in  the  treat- 
ment of,  274 

gangrene     of     the     sensitive 
structures  in,  268 

grooving    the     wall     in    the 
treatment  of.  278 

local  application  in  the  treat- 
ment  Of.   2/T, 

local   bleeding   in   the   treat- 
ment of,  272 

metastatic  colic  in.  268 

metastatic       pneumonia      in. 
268 

neurectomy  in,  292 

opening  the  sole  in  the  treat- 
ment of,  277 


parturient,  258 

pathological  anatomy  of,  264 
periostitis  and  ostitis  in,  269 
phlebotomy  in  the  treatment 

of,  272 
prognosis  in,  271 
rocker  bar  shoes  in  the  treat- 
ment of,  274 
Smith's  operation  in,  278 
suppuration  in,  26.7 
svmptoms  of,  260 
symptoms    of,    in    all    four 

feet,  261 
symptoms    of,    in    the    fore- 
feet alone,  262 
symptoms    of,    in    the    hind- 
feet  alone,  262 
treatment  of,  272 
Laminitis.  chronic,  282 

Bayer's  treatment  of,  291 
causes  of,  282 
definition  of,  282 
Gross's  treatment  of,  291 
Gunther's  treatment  of,  291 
Imminger's  treatment  of,  291 
Joly's  treatment  of,  292 
Meyer's  treatment  of,  291 
pathological  anatomy  of,  287 
surgical  shoeing  for,  291,  292 
symptoms  of,  283 
treatment  of,  289 
Laminitis,  parturient,  258 
Lateral  cartilage,  the,  30 

extirpation     of,     in     quittor, 
after     Moller    and    Frick, 

3=53 
extirpation    of,     in     quittor, 

after  Bayer,  355 
functions  of,  66 
necrosed,    pathological    anat- 
omy of,  339 
necrosis  of.  337 
ossification  of,  365 
wounds  of,  328 
Leg.  chronic  oedema  of  the,  after 

neurectomy.  104 
Length    of    rest    required    after 

neurectomy,   toi 
Ligaments,  the,   12 
Ligaturing  the  digital  arteries  in 

chronic  laminitis.  292 
Limb,  septic  infection  of,  217 
Local    applications    in    laminitis. 

Local  bleeding  in  laminitis,  272 
Local  or  coronary  contraction  of 

the  foot.  140 
Low  ringbone,  395 


454         DISEASES  OF  THE  HORSE'S  FOOT 


Malcolm's   treatment   of    canker, 
316 

McGill's  sand-crack  clamp,  172 

Median  neurectomy,  gg 

Metal  plates  in  the  treatment  of 
sand-crack,  173 

Metastatic  colic  in  laminitis,  268 

Metastatic  pneumonia  in   lamin- 
itis, 268 

Methods    of    applying    poultices, 
86 
of    examining    the    foot,    70, 

7?,  74 

of   immobilizing    sand-crack 
by  grooving  the  wall,   178 
Methods  of  restraint,  77^ 

of  securing  a  hind-limb  with 

the  side-line,  78,  7g 
of   securing  the  foot  to  the 
cannon    of    another    limb, 
81,  82 
Meyer's     treatment     of     chronic 

laminitis,  2gi 
Moist  corn,  ig5 

Nail-bound,  205 

causes  of,  205 

definition  of,  20S 

symptoms  of,  206 

treatment  of,  206 
Nail-tread,  207 
Navicular  bone,  the,  12 

fracture  of,  216 
Navicular  bursa,  puncture  of  the, 

in  pricked  foot,  216 
Navicular  bursa  punctured,  treat- 
ment of,  227 
Navicular  disease,  427 

causes  of,  433 

changes  in  the  bone  in,  43 l 

changes  in  the  bursa  in,  42g 

changes  in  the   cartilage  in, 
430 

changes  in  the  tendon  in,  431 

definition  of,  427 

diagnosis  of,  437 

differential  diagnosis   of,  441 

history  of,  428 

in  the  hind-feet,  441 

point   of  commencement   of, 
428 

prognosis  of,  443 

symptoms  of,  437 

treatment  of,  443 
Necrosed  lateral  cartilage, 

pathological  anatomy  of,  339 
Necrosis  of  bone,  387 

of    tendon    and    ligament    in 
subhorny  quittor,  340 


of  the  lateral  cartilage  (car- 
tilaginous quittor),  337 
Necrotic      plantar      aponeurosis, 

treatment  of,  222 
Nerve,    reunion    of,    after    neu- 
rectomy, tc.s 
Nerves,  the,  28 

Neurectomy,  advantages  of,  107 
amputational     neuroma     in, 

104 
fracture  of  the  bones  after, 

104 
gelatinous  degeneration  after, 

102 
history  of,  91 

instruments  required  in,  96 
in  laminitis,  292 
length  of  rest  required  after, 

ioj 
persistent  pruritus  after,  104 
pricked  foot  after,  101 
reunion     of     divided     nerve 

after,  105 
sequela?  of,  101 
stumbling  after,   107 
use  of  the  horse  after,  no 
Neurectomy,  median,  gg 

plantar,  gi 
Neuroma,      amputational,     after 
neurectomy,  104 

(Edema    of    the    leg    after    neu- 
rectomy,  104 
Opening   the    sole   in    the    treat- 
ment of  laminitis,  277 
Operation  for  complicated  sand- 
crack,  180 
for  laminitis,  278 
for  necrosed  lateral  cartilage 

in  quittor,  351 
for  necrosed    plantar    apon- 
eurosis, 222 
for  side-bone,  372 
Operations    on   the    foot,   instru- 
ments required  in,  83 
Operations    on    the    horn,    treat- 
ment   of    contracted    foot    by, 
137 
Os  coronse,  the,  7 

dislocation  of,  447 
fracture  of,  402 
Os  pedis,  the,  g 

caries    of,    in    pricked    foot, 

217 
fracture  of,  407 
Osteoplastic  ostitis,  387 
Osteoplastic  periostitis,  384 
Ostitis  in  laminitis,  269 


INDEX 


455 


Ostitis,  rarefying,  386 

osteoplastic,  387 
Ossification  of  the  lateral  carti- 
lages (side-bone),  365 
Overreach,  229 

shoeing  for,  23-, 

treatment  of,  238 

Parturient  laminitis,  258 
Pathological    anatomy    of    acute 
laminitis,  264 

of  canker,  310 

of  chronic  laminitis,  287 

of  corn,  iqi 

of  keraphyllocele,  301 

of  necrosed  lateral  cartilage, 

339 

of  pyramidal  disease,  397 
of  simple    cutaneous    quittor, 

332  . 
of  navicular  disease,  428 
Pedal    articulation,    puncture    of 

the,  216 
Perforans     tendon,     the     flexor 

pedis,   18 
Perforatus     tendon,     the     flexor 

pedis,   19 
Periople,  the,  43 
Periostitis   and   ostitis   in  lamin- 
itis, 269 
Periostitis,  osteoplastic,  384 
Periostitis,    recorded     cases     of, 

389    .  .      . 

Periostitis,  simple  acute,  382 

suppurative,  383 
Periostitis,  treatment  of,  388 
Persistent    pruritus    after    neu- 
rectomy,  104 
Phlebotomy  in  laminitis,  272 
Plantar  aponeurosis,   wounds  of 
the,  215 
treatment  of  necrosed,  222 
Plantar  cushion,  the,  32 
Plantar  neurectomy,  91 
history  of,  91 

instruments  required  in,  96 
operation  of,  92 
Pneumonia    in    laminitis,    metas- 
tatic, 268 
Point  of  commencement  of  nav- 
icular disease,  428 
Poultices,   methods   of   applying, 

86 
Preventive    treatment    of    cutan- 
eous quittor,  333 
Pricked  foot,  207 

after  neurectomy,  101 
complications  of,  214 


Prognosis    in    acute    simple   cor- 
onitis,  234 
in  canker,  314 
in  contracted  foot,  124 
in  corn,  196 
in  laminitis,  271 
in  navicular  disease,  443 
in  punctured  foot,  217 
in  sand-crack,  169 
in  simple  cutaneous  quittor, 
332 
Properties  of  horn,  chemical,  58 
Protection     of     sand-crack     by 

metal  plates,   173 
Pruritus  after  neurectomy,   104 
Pumiced  foot,  146 
causesof,  146 
definition  of,  146 
symptoms  of,  \a6 
treatment  of,  147 
Punctured  foot,  207 
causes  of,  207 
classification  of,  207 
common     situation     of     the 

wound  in,  209 
complications  in,  214 
definition  of,  207 
diagnosis  of,  210 
prognosis  of,  217 
symptoms  of,  210 
treatment  of,  219 
Puncture  of  the  navicular  bursa, 
21S 
treatment  of,  227 
Puncture  of   the   pedal   articula- 
tion, 216 
Purulent  synovitis,  417 
Pyramidal  disease,  395 

Quittor,  329 

classification  of,  329 

definition  of,  329 
Quittor,     simple     or     cutaneous, 
330 

causes  of,  330> 

complications  in,  332 

curative  treatment  of,  333 

definition  of,  330 

pathological  anatomy  of,  332 

preventive  treatment  of,  333 

prognosis  of,  332 

symptoms  of,  331 

treatment  of,  333 
Quittor,  sub-horny,  335 

causes  of.  335 

complications  in,  3,3,7 

definition  of,  335 

diagnosis  of,  336 

extirpation     of     the     lateral 


456 


DISEASES  OE  THE  HORSE'S  FOOT 


cartilage    in,    after  Moller 
and  Frick,  353 

extirpation     of     the  lateral 

cartilage    in,    after  Bayer, 

355 

necrosis  of  the  lateral  car- 
tilage in  (cartilaginous 
quittor),  337 

necrosis  of  tendon  and  lig- 
ament in  (tendinous  quit- 
tor),  340 

surgical  shoeing  in,  364 

symptoms   of,  336 

treatment  of,  342 

Rarefying  ostitis,  386 
Recorded  case  of  dislocation  of 
the  os  coronae,  447 
of  navicular  disease  in  both 

hind-feet,  441 
of  periostitis,  389 
of  pyramidal  disease,  397 
Rest  required  after  neurectomy, 

length  of,  101 
Restraint,  methods  of,  77 
Reunion    of    the    divided    nerve 

after  neurectomy,  105 
Ringbone,  low,  395 
Ringed  hoof,  149 
causes  of,  149 
definition  of,  149 
treatment  of,  150 
Rocker    bar    shoes    in    laminitis, 

274 
Rose's  treatment  of  canker,  322 

Sand-crack,  161 
causes  of,  161 
clamp,  Koster's,  173 
McGill's,  172 
Vachette's,    171 
clamping,  methods  of,  171 
classification  of,  161 
complications  in,  168 
definition  of,  161 
operations    for    complicated, 

180 
prognosis  in,  169 
surgical    shoeing    for,    175 
symptoms  of,  165 
treatment  of,  170 
treatment    of,    by    grooving 

the  wall,  178 
treatment    of,     by     wedging 
the  fissure,  175 
Second  interphalangeal  articula- 
tion, the,  15 
Securing    a    hind-limb    with    the 
side-line,  method  of,  78,  79 


Securing  the  foot  to  the  cannon 
of    another    limb,    method    of, 
81,   82 
Seedy-toe,  293 
causes  of,  293 
definition  of,  293 

symptoms  of,  294 

treatment  of,  296 
Senile  decay  as  a  cause  of  navi- 
cular disease,  437 
Sensitive  laminae,  the,  36 
Sensitive     structures,     gangrene 

of,  in  laminitis,  268 
Septic  infection  of  the  limb,  217 
Sequelae  of  neurectomy,   101 
Serous  arthritis,  417 
Shoe,  bar,  128 

Charlier's,  126 

Charlier's  tip,  127 

expansion,   Broue's,    135 
De  Fay's,  133 
Einsiedel's,  136 
Hartmann's,   134 
Smith's,   130 

for  overreach,  236 

plate,  90 

rocker  bar,  274 

slipper,     Broue's,     135 

slipper  and  bar-clip,  Einsie- 
del's, 136 

three-quarter,  201 

three-quarter  bar,  201 

thinned  tip,  126 

tip,  125,  126 

with  '  dropped  '   heel,  202 

with  extended  toe-piece,  156 

with      extended      toe  -  piece 

(Nunn's),  228 

with  heel-clip,  291 

with  'set '  heel,  202 
Side-bone,  365 

causes  of,  368 

definition  of,  365 

diagnosis  of,  365 

heredity  a  cause  of,  370 

Smith's  operation  for,  372 

symptoms  of,  365 

treatment  of,  371 
Side-line,  the,  78 
Simple  acute  coronitis,  229 
Simple  acute  periostitis,  382 
Simple  coronitis,  acute,  229 

chronic,  240 
Simple  or  cutaneous  quittor,  330 

causes  of,  330 

complications  in,  332 

curative  treatment  of,  333 

definition  of,  330 

pathological  anatomy  of,  332 


INDEX 


457 


preventive  treatment  of,  333 

prognosis  of,  332 

symptoms  of,  331 

treatment  of,  333 
Simple  serous  arthritis,  417 
Simple  synovitis,  acute,  413 
Smith's  expansion  shoe,  130 

operation   for   laminitis,  278 

operation  for  side-bone,  372 
Solar   edge   of  the   wall,   expan- 
sion   and    contraction    of    the, 

6S 
Sole,  chronic  bruised,  203 
Sole,   expansion   and  contraction 

of  the,  66 
Sole,  the,  40 
Specific  coronitis,  324 

causes  of,  325 

definition  of,  324 

symptoms  of,  325 

treatment  of,  326 
Spongy  hoof,  1=52 

definition  of,  152 

symptoms  of,  152 

treatment  of,  153 
Stumbling  after   neurectomy,  107 
Sub-horny  quittor,  335 

causes  of:  335 

complications  in,  337 

definition  of,  335 

diagnosis  of,  336 

necrosis  of  the  lateral  car- 
tilage in  (cartilaginous 
quittor),  337 

necrosis  of  tendon  and  liga- 
ment in  (tendinous  quit- 
tor),  340 

symptoms  of,  326 

treatment  of,  342 

surgical  shoeing  for,  364 
Suppurating  corn,  193 
Suppuration   in  laminitis,  267 
Suppurative  arthritis,  418 

causes  of,  418 

definition  of,  418 

diagnosis  of,  419 

pathology  of,  ..22 

symptoms  of,  410, 

treatment  of,  424 
Suppurative  periostitis,  383 
Suppurative  synovitis,  417 
Surgical  shoeing  for  corn,  200 

for  chronic  laminitis,  2Qi, 
292 

for  laminitis,  acute,  274 

for  sand-crack,  175 

for  quittor,  364 
Symptoms   of  acute   simple  cor- 
onitis, 231 


of  brittle  hoof,  150 

of  canker,  310 

of  chronic  coronitis,  241 

of  chronic  laminitis,  283 

of  club-foot,  154 

of  contracted  foot,  117 

of  corn, igo 

of    coronary    contraction    of 

the  foot,  140 
of  crooked  foot,  157 
of  false  quarter,  245 
of  flat-foot,  143 
of  keraphyllocele,  300 
of  laminitis,  260 
of  laminitis  in  all  four  feet, 

261 
of  laminitis   in  the   fore-feet 

alone,  262 
of  laminitis  in  the  hind-feet 

alone,  262 
of  nail-bound,  206 
of  navicular  disease,  437 
of  pumiced  foot,  146 
of  punctured  foot,  210 
of  pyramidal  disease,  396 
of  sand-crack,  i(j$ 
of  seedy-toe,  294 
of  side-bone,  365 
of  simple   chronic   coronitis, 

241 
of  simple  cutaneous  quittor, 

of  specific  coronitis,  325 

of  spongy  hoof,   152 

of  sub-horny  quittor.  336 

of  synovitis,  chronic,  415 

of  synovitis,  purulent  or  sup- 
purative, 417 

of    synovitis,    simple    acute, 
418 

of  thrush,  304 

of  weak  heels,  115 
Synovitis,  acute  simple,  413 

causes  of,  413 

treatment  of,  416 

Tearing  off  of  the  entire  hoof, 

accidental,  247 
Tendon,  the  extensor  pedis,  17 
the    flexor   pedis,    perforans, 

18 
the    flexor   pedis   perforatus, 
19 
Tendons,  the,  17 
Thrush,  303 

causes  of,  303 
definition  of,  303 
symptoms  of,  304 
treatment  of,  30.=; 


458 


DISEASES  OF  THE  HORSE'S  FOOT 


Tight-nailing,  2055 
Tip-shoes,  125 
Tissue,  the  velvety,  35 
Tread,  229.     See  Overreach 
Treatment     of     acute     laminitis, 
272 
of  acute  simple  coronitis,  235 
of  brittle  hoof,  151 
of  canker,  314 
of  canker,  Bermbach's,  321 
Hoffman's,  321 
Imminger's,  321 
Malcolm's,  316 
Rose's,  322 
of  chronic  bruised  sole,  204 
of  chronic  coronitis,  242 
of  chronic  laminitis,  280 
of   chronic   laminitis  by  lig- 
aturing  the    digital    arter- 
ies, 292 
of  club-foot,  155 
of  contracted  feet,  125 
of  contracted  feet  by  expan- 
sion  shoes,   130 
of  contracted  feet  by  opera- 
tions on  the  horn,  137 
of  corns,  197 
of    coronary   contraction    of 

the  foot,  143 
of  crooked  foot,  158 
of  curved  hoof,  160 
of  cutaneous  quittor,  333 
of  false  quarter,  246 
of  keraphyllocele,  302 
of  nail-bound,  206 
of  navicular  disease,  443 
of  necrotic   plantar    aponeu- 
rosis, 222 
of  periostitis,  388 
of  pumiced  foot,   147 
of  punctured  foot,  219 


of  punctured  navicular  bursa, 

227 
of  pyramidal  disease,  397 
of  ringed  hoof,  150 
of  sand-crack,  170 
of    sand-crack    by    clamping 

the  fissure,  171 
of    sand-crack    by    grooving 

the  wall,  178 
of    sand-crack    by    wedging 

the  fissure,  175 
of  seedy-toe,  2g6 
of  side-bone,  371 
of   simple  chronic  coronitis, 

242 
of  specific  coronitis,  326 

of  spongy  hoof,  153 

of  sub-horny  quittor,  342 

of  synovitis,  416 

of  thrush,  305 

of  weak  heels,  116 

Use   of   the   horse   that  has   un- 
dergone neurectomy,  no 

Vachette's  sand-crack  clamp,  171 
Veins,  the,  27 
Velvety  tissue,  the  35 
Villate's  caustic   solution,   199 

Wall,  the,  37 
Weak  heels,  115 
causes  of,  116 
definition  of,  115 
symptoms  of,  115 
treatment  of,  116 
Wedging     in      punctured      foot, 
common  situations  of  the,  209 
Wounds    of    the    lateral    carti- 
lages, 217,  328 
Wounds  of  the  plantar  aponeu- 
rosis, 215 


THE    END 


Webster  Family  library  of  Veterinary  Medicine 
Cummings  School  of  Veterinary  Medicine  at 
Tufts  University 
200  Westboro  Road 
North  Grafton,  MA  01536 


